Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Other names
Jackson Family Medicine Pike Road
Organization subpart
No
Provider details
NPI number
Authorized official
KELIN PENNEY (ADMINISTRATOR)
(334) 240-2335
Entity
Organization
Contact information
Practice address
11123 CHANTILLY PKWY CT, STE M, PIKE ROAD, AL 36064-2880
(334) 293-8888
Mailing address
1722 PINE ST, STE 503, MONTGOMERY, AL 36106-1103
(334) 293-8888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/04/2013
Last updated
05/21/2019
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