Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackson Physician Corp

Organization Pediatric Urology Physician · NPI 1023219425

Jackson Physician Corp is a Pediatric Urology Physician in Jackson, Kentucky. Licensed in Kentucky. Registered with an NPI since 2007.

Licensed in
KY
In the registry since
2007
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1550 Highway 15 S Ste 27
Jackson, KY 41339-8604
Phone: (606) 693-0116
Fax: (606) 693-0118
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Urology Physician (primary) Taxonomy 2088P0231X · Licence 25492 (KY)

Record details

NPI number1023219425
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Loretta Campbell — Clinic Coordinator · (606) 693-0531
Other names Dba Jackson Urology
NPI enumeratedMay 31, 2007
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 790, Jackson, KY 41339-0790