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Organization
JACKSON HOSPITAL AND CLINIC, INC.
Active
Organization
JACKSON HOSPITAL AND CLINIC, INC.
Active
Other names
Jackson Clinic Vascular Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
KELIN PENNEY (EXECUTIVE DIRECTOR)
(334) 240-2335
Entity
Organization
Contact information
Practice address
1725 PARK PL, SUITE 300-A, MONTGOMERY, AL 36106-1123
(334) 293-8000
Mailing address
1722 PINE ST STE 804, MONTGOMERY, AL 36106-1108
(334) 270-9914
(334) 270-3195
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
NULL
Other
Enumeration date
06/27/2011
Last updated
10/08/2026
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