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Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Other names
Jackson Family Medicine Dalraida
Organization subpart
No
Provider details
NPI number
Authorized official
TARA HERRING (REVENUE CYCLE DIRECTOR)
(334) 240-2337
Entity
Organization
Contact information
Practice address
4035 ATLANTA HWY, MONTGOMERY, AL 36109-2920
(334) 603-8708
(334) 603-8709
Mailing address
1722 PINE ST STE 203, MONTGOMERY, AL 36106-1158
(334) 293-8736
(334) 293-8738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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