Jackson Hospital And Clinic, INC
Internal Medicine, Endocrinology, Diabetes & Metabolism in Montgomery, AL. Organization (NPI-2).
NPI number1376115246
StatusActive
Last updated in NPPESJul 12, 2021
Details
- NPI
- 1376115246
- Entity type
- Organization (NPI-2)
- Legal business name
- Jackson Hospital And Clinic, INC
- Organization subpart
- No
- Enumeration date
- Jul 12, 2021
- Certification date
- Jun 15, 2021
- Last updated
- Jul 12, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RE0101X | Internal Medicine, Endocrinology, Diabetes & Metabolism | – | – | Yes |
Other names
- Jackson Clinic Endocrinology Suite 202 (Doing Business As)
Practice location
1801 Pine St Ste 202Montgomery, AL 36106-1154
Phone 334-293-8877 · Fax 334-293-6803
Mailing address
1722 Pine St Ste 203Montgomery, AL 36106-1158
Phone 334-293-8736 · Fax 334-293-8738
Authorized official
Tara Herring
Revenue Cycle Director
3342938736
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