Organization
JACKSON WOMENS CARE
Active
Organization
JACKSON WOMENS CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA L CAMPBELL (CLINIC COORDINATOR)
(606) 693-0531
Entity
Organization
Contact information
Practice address
540 JETT DR, JACKSON, KY 41339-9622
(606) 666-6240
Mailing address
PO BOX 790, JACKSON, KY 41339-0790
(606) 666-6240
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
21623
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65926974
—
KY
Enumeration date
05/16/2007
Last updated
08/22/2020
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