Organization
JACKSON HOSPITAL AND CLINIC, INC.
Active
Other names
Jackson Clinic Urology
Organization subpart
No
Provider details
NPI number
Authorized official
KELIN PENNEY (EXECUTIVE DIRECTOR)
(334) 240-2335
Entity
Organization
Contact information
Practice address
1722 PINE ST, SUITE 502, MONTGOMERY, AL 36106-1103
(334) 293-8588
Mailing address
1722 PINE ST STE 804, MONTGOMERY, AL 36106-1108
(334) 293-8736
(334) 270-3195
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD.31014
AL
Other
Enumeration date
07/12/2011
Last updated
03/09/2026
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