DBA JACKSON UROLOGY
NPI 1023219425
Urology - Pediatric Urology in Jackson, KY

Q: What is Jackson Physician Corp's NPI number?

The NPI number for Jackson Physician Corp is 1023219425. It was assigned to this organization in the NPPES registry on May 31, 2007. The provider is doing business as Dba Jackson Urology.

Q: What is Jackson Physician Corp's specialty?

The primary specialty registered for this NPI is Urology, specializing in Pediatric Urology, with taxonomy code 2088P0231X.

Active since May 31, 2007

1550 HIGHWAY 15 S STE 27, JACKSON, KY 41339(606) 693-0116(606) 693-0118 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dba Jackson Urology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DBA JACKSON UROLOGY (NPI 1023219425) is a healthcare organization registered as a pediatric urology in Jackson, Kentucky and active in the NPI registry since May 2007. The organization lists Loretta L Campbell, Clinic Coordinator, as its authorized official.

NPPES Registry Identity

NPI1023219425

Entity TypeOrganization

Primary Taxonomy2088P0231X

Legal Business NameJACKSON PHYSICIAN CORP

Location Address1550 HIGHWAY 15 S STE 27Jackson, KY 41339-8604

Mailing AddressPo Box 790Jackson, KY 41339-0790 · (606) 693-0531 · Fax (606) 693-0535

Phone(606) 693-0116

Fax(606) 693-0118

Organization SubpartNo

Authorized OfficialLoretta L CampbellClinic Coordinator · (606) 693-0531

Enumeration DateMay 31, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1023219425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrology · Pediatric UrologyAllopathic & Osteopathic Physicians

Taxonomy Code2088P0231X

License✔ Licensed in KY · 25492

Definition

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).

1550 HIGHWAY 15 S STE 27, Jackson, KY 41339

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Other Names 1

Doing Business AsDba Jackson Urology

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Physician Corp's NPI number?

The NPI number for Jackson Physician Corp is 1023219425. It was assigned to this organization in the NPPES registry on May 31, 2007. The provider is doing business as Dba Jackson Urology.

Where is Jackson Physician Corp located?

Jackson Physician Corp is located at 1550 Highway 15 S Ste 27, Jackson, KY 41339. The listed phone number is (606) 693-0116.

What is Jackson Physician Corp's specialty?

The primary specialty registered for this NPI is Urology, specializing in Pediatric Urology, with taxonomy code 2088P0231X.

When was this NPI record last updated?

The NPPES record for Jackson Physician Corp was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.