# JACKSON HOSPITAL AND CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JACKSON HOSPITAL AND CLINIC, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1528755378
- **Legal business name:** JACKSON HOSPITAL AND CLINIC, INC
- **Authorized official:** MELODY COWDREY (DIRECTOR-PATIENT FINANCIAL SERVICES)
- **Authorized official phone:** (334) 293-8147

## Contact information

- **Practice address:** 1725 PINE ST, MONTGOMERY, AL 36106-1109
- **Practice address phone:** (334) 293-8000
- **Mailing address:** 1725 PINE ST, MONTGOMERY, AL 36106-1109
- **Mailing address phone:** (334) 293-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 04/21/2023
- **Last updated:** 04/21/2023