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Organization

JACKSON CLINIC UROLOGY-DR NEWMAN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BENJAMIN WELLS JR. (CHIEF FINANCIAL OFFICER)
(334) 293-8000
Entity
Organization

Contact information

Practice address
1722 PINE STREET, SUITE 903, MONTGOMERY, AL 36106-1158
(334) 265-6933
(334) 265-7415
Mailing address
1725 PINE STREET, ATTN: PATIENT FINANCIAL SERVICES, MONTGOMERY, AL 36106-1109
(334) 293-8736
(334) 293-8738

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
8045
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000082994
AL
01
010003281
TRAVLERS RAILROAD
AL
01
82994
BLUE CROSS
AL
Enumeration date
01/17/2007
Last updated
12/28/2023
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