NPI 1023219425

Jackson Physician Corp

Organisation Pediatric Urology Physician Jackson, KY

Practice location

Address: 1550 Highway 15 S STE 27, Jackson, KY 41339-8604
Phone: (606) 693-0116
Fax: (606) 693-0118
Mailing address: PO Box 790, Jackson, KY 41339-0790

Authorised official

Name: Loretta L Campbell
Title: Clinic Coordinator
Phone: (606) 693-0531

Registered specialties

Pediatric Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2088P0231X Licence 25492 (KY)

Other Urology providers in Kentucky →

Registry record

NPI: 1023219425
Entity type: Organization
NPI issued: 31 May 2007
Record last updated: 22 Aug 2020

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.