Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Other names
Jackson Clinic Gastroenterology Prattville
Organization subpart
No
Provider details
NPI number
Authorized official
KELIN PENNEY (ADMINISTRATOR)
(334) 240-2335
Entity
Organization
Contact information
Practice address
707 MCQUEEN SMITH RD S, PRATTVILLE, AL 36066-7503
(334) 293-6825
(334) 293-6826
Mailing address
1722 PINE ST STE 503, MONTGOMERY, AL 36106-1160
(334) 293-8736
(334) 293-8738
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
01/25/2018
Last updated
01/25/2018
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