| NPI | 1316447063 |
|---|---|
| Doing Business As | JACKSON CLINIC GASTRO STE 406 |
| Entity Type | Organization |
| Authorized Contact | SHALICIA WALKER Enrollment & Credentialing COO Rd. 334-293-8736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2023-10-23 |