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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACKSON PHYSICIAN CORP

Active Organization

JACKSON PHYSICIAN CORP is a Pediatric Urology organization located in JACKSON, Kentucky. NPI 1023219425 is currently active in the NPPES registry. Verify at CMS.

Pediatric Urology · JACKSON, KY

Registration Details

NPI Number
1023219425
Provider Type
Organization
NPI Issued
May 31, 2007 (19.224092643532 yrs)
Last Updated
Aug 22, 2020
License
25492 (KY)

Practice Information

Address
1550 HIGHWAY 15 S STE 27
JACKSON, KY, 413398604
Browse KY providers · Browse ZIP 41339
Phone
6066930116
Fax
6066930118
Primary Specialty
Pediatric Urology
2088P0231X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.