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Organization

JACKSON HOSPITAL CORPORATION

Active
Parent organization
JACKSON HOSPITAL CORPORATION
Other names
Kentucky River ER, Anesth, Radiology
Organization subpart
Yes

Provider details

NPI number
Legal business name
JACKSON HOSPITAL CORPORATION
Authorized official
DEBBIE T BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization

Contact information

Practice address
540 JETT DR, JACKSON, KY 41339-9622
(606) 666-6000
(606) 666-6107
Mailing address
540 JETT DR, JACKSON, KY 41339-9622
(606) 666-6000
(606) 666-6107

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
207P00000X
Emergency Medicine Physician
Primary
2085R0202X
Diagnostic Radiology Physician
367500000X
Certified Registered Nurse Anesthetist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65938276
KY
05
74900580
KY
Enumeration date
05/31/2007
Last updated
06/26/2008
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