Organization
JACKSON PHYSICIAN CORP
Active
Other names
Jackson Foot and Ankle Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
424 JETT DR, JACKSON, KY 41339-9621
(606) 666-5354
(606) 666-4857
Mailing address
424 JETT DR, JACKSON, KY 41339-9621
(606) 666-5354
(606) 666-4857
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TN
363L00000X
Nurse Practitioner
—
KY
Other
Enumeration date
10/28/2010
Last updated
05/17/2012
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