JACKSON CLINIC CARDIOLOGY – NPI #1811350390
Internal Medicine

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 CLINIC CARDIOLOGY is a provider located in PRATTVILLE, AL. NPPES has assigned the NPI number 1811350390 to JACKSON CLINIC CARDIOLOGY on April 01, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “JACKSON CLINIC CARDIOLOGY” is a dba name, the actual legal business name for this organization is JACKSON HOSPITAL AND CLINIC INC.. The primary taxonomy selected by this provider is 207RC0000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Cardiovascular Disease

The NPI profile was previously updated about 10 years ago on Apr 07, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JACKSON CLINIC CARDIOLOGY below.

NPI Profile for
JACKSON HOSPITAL AND CLINIC INC.

NPI Number
1811350390
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
JACKSON HOSPITAL AND CLINIC INC.
Doing Business As (dba): JACKSON CLINIC CARDIOLOGY
Primary location
124 S MEMORIAL DR
PRATTVILLE, AL 36067-3619
Phone: (334) 264-9191 Fax: (334) 264-9199
Mailing address
1722 PINE ST
SUITE 503
MONTGOMERY, AL 36106-1103
Phone: (334) 293-8736 Fax: (334) 293-6859
Organization Subpart
No
Authorized Official
KELIN PENNEY
ADMINISTRATOR
Phone: (334) 240-2335
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RC0000X
- Internal Medicine / Cardiovascular Disease (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.