# ST DOMINIC MEDICAL ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST DOMINIC JACKSON MEMORIAL HOSPITAL
- **Other names:** St Dominic Family Practice Brandon
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1548698608
- **Legal business name:** ST DOMINIC JACKSON MEMORIAL HOSPITAL
- **Authorized official:** JENNIFER SINCLAIR (PRESIDENT OF SDMA)
- **Authorized official phone:** (601) 200-2000

## Contact information

- **Practice address:** 1297 WEST GOVERNMENT STREET, BRANDON, MS 39042
- **Practice address phone:** (601) 200-4790
- **Practice address fax:** (601) 200-4855
- **Mailing address:** PO BOX 23666, JACKSON, MS 39225-3666
- **Mailing address phone:** (601) 200-4749
- **Mailing address fax:** (601) 200-5929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 18818 | MS | Yes |

## Other

- **Enumeration date:** 10/28/2013
- **Last updated:** 12/30/2016