Organization
JACKSON HOSPITAL AND CLINIC, INC.
Active
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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