JACKSON HOSPITAL AND CLINIC INC NPI 1912362773

NPI Information

JACKSON HOSPITAL AND CLINIC INC is a cardiovascular disease internal medicine in Montgomery, AL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. JACKSON HOSPITAL AND CLINIC INC NPI is 1912362773. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Jackson Clinic Cardiology.

The provider's business location address is:

1758 PARK PL
SUITE 401
MONTGOMERY, AL
ZIP 36106-127
Phone: (334) 264-9191
Fax: (334) 264-9821

The provider's authorized official is Kelin Penney .
The authorized official title is Administrator and has the following contact phone number (334) 240-2335.

The CLIA number assigned to this NPI record is 01D2033163 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2015 and was last updated on 12/22/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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