NPI 1013433820

Jackson Hospital & Clinic, INC.

Organisation Urology Physician Tallassee, AL

Practice location

Address: 80 Herren Hill Rd STE C, Tallassee, AL 36078-1264
Phone: (334) 293-8588
Fax: (334) 293-6978
Mailing address: 1722 Pine St STE 804, Montgomery, AL 36106-1108

Authorised official

Name: Kelin Penney
Title: Executive Director
Phone: (334) 240-2335

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X

Other Urology providers in Alabama →

Registry record

NPI: 1013433820
Entity type: Organization
NPI issued: 15 Aug 2017
Record last updated: 9 Mar 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.