| NPI | 1588011746 |
|---|---|
| Doing Business As | JACKSON VASCULAR SURGERY |
| Entity Type | Organization |
| Authorized Contact | KELIN PENNEY Administrator 334-240-2335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |