Organization
JACKSON HOSPITAL AND CLINIC, INC.
Active
Other names
Jackson Clinic Prattville Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
TARA HERRING (REVENUE CYCLE DIRECTOR)
(334) 293-8736
Entity
Organization
Contact information
Practice address
204 MEDICAL CENTER DR, PRATTVILLE, AL 36066-7288
(334) 361-3090
(334) 361-2090
Mailing address
1722 PINE ST STE 203, MONTGOMERY, AL 36106-1158
(334) 293-8736
(334) 293-8738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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