Organization
JACKSON PHYSICIAN CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA J FEY (SR. DIRECTOR PHYSICIAN REV CYCLE)
(615) 221-3641
Entity
Organization
Contact information
Practice address
424 JETT DR, JACKSON, KY 41339-9621
(066) 936-4830
Mailing address
PO BOX 5009, BRENTWOOD, TN 37024-5009
(615) 221-3641
(615) 221-1484
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65930364
—
KY
Enumeration date
06/15/2006
Last updated
11/12/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us