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JACKSON PHYSICIAN CORP NPI 1023219425


NPI Information

NPI: 1023219425
Provider Name: JACKSON PHYSICIAN CORP

Doing Business As: DBA JACKSON UROLOGY

Classification: Urology - 2088P0231X
Entity Type: Organization

Specialization: Pediatric Urology

Address:
1550 HIGHWAY 15 S STE 27
JACKSON, KY
ZIP 41339
Phone: (606) 693-0116
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JACKSON PHYSICIAN CORP is a pediatric urology urology in Jackson, KY. The provider is surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). JACKSON PHYSICIAN CORP NPI is 1023219425. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dba Jackson Urology.

The provider's business location address is:

1550 HIGHWAY 15 S STE 27
JACKSON, KY
ZIP 41339-604
Phone: (606) 693-0116
Fax: (606) 693-0118

The provider's authorized official is Loretta L Campbell .
The authorized official title is Clinic Coordinator and has the following contact phone number (606) 693-0531.

The enumeration date for this NPI number is 5/31/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12088P0231XUrologyPediatric Urology25492KENTUCKYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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