Organization
IMC-FAMILY MEDICAL OF JACKSON, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIDNEY S CROSBY M.D. (PRESIDENT)
(251) 246-4446
Entity
Organization
Contact information
Practice address
227 HOSPITAL DR, JACKSON, AL 36545-2423
(251) 246-4446
(251) 246-5111
Mailing address
227 HOSPITAL DR, JACKSON, AL 36545-2423
(251) 246-4446
(251) 246-5111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529700760
—
AL
01
—
541003926
MEDICAID GROUP #
AL
05
—
541003926
—
AL
Enumeration date
08/12/2006
Last updated
02/23/2018
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