# ALABAMA SPORTS, SPINE & OCCUPATIONAL MEDICINE ASSOCIATES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740576610
- **Authorized official:** MR. MICHAEL DONIAL JACKSON MD (PRESIDENT)
- **Authorized official phone:** (319) 350-2208

## Contact information

- **Practice address:** 242 WINTON BLOUNT LOOP, MONTGOMERY, AL 36117-3501
- **Practice address phone:** (319) 350-2208
- **Mailing address:** 242 WINTON BLOUNT LOOP, MONTGOMERY, AL 36117-3501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2011
- **Last updated:** 06/21/2011