# ST DOMINIC MEDICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST DOMINIC JACKSON MEMORIAL HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033413174
- **Legal business name:** ST DOMINIC JACKSON MEMORIAL HOSPITAL
- **Authorized official:** JENNIFER SINCLAIR (VP OF FINANCE)
- **Authorized official phone:** (601) 200-2000

## Contact information

- **Practice address:** 5520 HIGHWAY 80 E, PEARL, MS 39208-8926
- **Practice address phone:** (601) 200-2000
- **Mailing address:** PO BOX 23666, JACKSON, MS 39225-3666
- **Mailing address phone:** (601) 200-2779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/04/2011
- **Last updated:** 01/04/2011