Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Other names
Jackson Clinic Colorectal Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
TARA HERRING (REVENUE CYCLE DIRECTOR)
(334) 293-8736
Entity
Organization
Contact information
Practice address
1722 PINE ST STE 402, MONTGOMERY, AL 36106-1159
(334) 293-8736
(334) 293-8738
Mailing address
1722 PINE ST STE 203, MONTGOMERY, AL 36106-1158
(334) 293-8736
(334) 293-8738
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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