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Organization
JACKSON HOSPITAL AND CLINIC INC
Active
Organization
JACKSON HOSPITAL AND CLINIC INC
Active
Other names
Jackson Vascular Surgery Greenville
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELIN PENNEY (ADMINISTRATOR JACKSON CLINIC)
(334) 240-2335
Entity
Organization
Contact information
Practice address
44 MEDICAL ARTS CT, GREENVILLE, AL 36037-3869
(334) 293-8922
(334) 293-6820
Mailing address
1722 PINE ST, SUITE 503, MONTGOMERY, AL 36106-1103
(334) 240-2337
(334) 293-6859
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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