# JACKSON HOSPITAL AND CLINIC INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Jackson Vascular Surgery Greenville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740657683
- **Authorized official:** MS. KELIN PENNEY (ADMINISTRATOR JACKSON CLINIC)
- **Authorized official phone:** (334) 240-2335

## Contact information

- **Practice address:** 44 MEDICAL ARTS CT, GREENVILLE, AL 36037-3869
- **Practice address phone:** (334) 293-8922
- **Practice address fax:** (334) 293-6820
- **Mailing address:** 1722 PINE ST, SUITE 503, MONTGOMERY, AL 36106-1103
- **Mailing address phone:** (334) 240-2337
- **Mailing address fax:** (334) 293-6859

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/26/2015
- **Last updated:** 08/26/2015