Jackson Ent Clinic , Psc

NPI #1831225465 in Jackson, Kentucky

Provider Information

NPI Number: 1831225465
Entity Type: Organization
Organization Name: Jackson Ent Clinic , Psc
Primary Specialty: Otolaryngology
Enumeration Date: Feb 26, 2007
Last Updated: Nov 14, 2008

Practice Location

Address: 1550 HIGHWAY 15 S STE 29
City: Jackson
State: Kentucky
ZIP Code: 41339-9221
Phone: (606) 666-9909

Authorized Official

Name: DR. TARIQ A SARTAWI, M.D.
Title: OWNER
Phone: (606) 666-9909

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Oral & Maxillofacial Surgery	204E00000X
Otolaryngology	207Y00000X	Primary

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