Graduated: 1990
NPI: 1245226612
Practice Locations (2)
JACKSON HOSPITAL AND CLINIC, INC
1725 PINE ST
MONTGOMERY, AL 361061109
3342938123
ULTRACARE MEDICAL SERVICES LLC
215 WINTON BLOUNT LOOP
MONTGOMERY, AL 361173507
3342399480
Source: CMS National Downloadable File, September 2026.