Organization
JACKSON HOSPITAL AND CLINIC INC.
Active
Other names
Jackson Clinic Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
KELIN PENNEY (ADMINISTRATOR)
(334) 240-2335
Entity
Organization
Contact information
Practice address
461 E MAIN ST, PRATTVILLE, AL 36067-3409
(334) 264-9191
(334) 264-9199
Mailing address
1722 PINE ST, SUITE 503, MONTGOMERY, AL 36106-1103
(334) 240-2337
(334) 293-6859
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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