Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
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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