Organization
JACKSON HOSPITAL AND CLINIC INC
Active
Other names
Jackson Clinic Cardiothoracic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
KELIN PENNEY (EXECUTIVE DIRECTOR)
(334) 240-2335
Entity
Organization
Contact information
Practice address
1758 PARK PL, SUITE 202, MONTGOMERY, AL 36106-1127
(334) 264-7156
(334) 264-7681
Mailing address
1722 PINE ST STE 804, MONTGOMERY, AL 36106-1108
(334) 293-8736
(334) 293-8738
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
03/27/2017
Last updated
03/09/2026
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