Organization
JACKSON HOSPITAL AND CLINIC INC.
Active
Other names
Jackson Vascular Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
KELIN PENNEY (ADMINISTRATOR)
(334) 240-2335
Entity
Organization
Contact information
Practice address
1801 PINE ST, SUITE 101, MONTGOMERY, AL 36106-0165
(334) 293-8922
(334) 293-6820
Mailing address
1722 PINE ST, SUITE 503, MONTGOMERY, AL 36106-1103
(334) 293-8736
(334) 293-6859
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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