Organization
ST. DOMINIC MEDICAL ASSOCIATES LLC
Active
Parent organization
ST. DOMINIC JACKSON MEMORIAL HOSPITAL
Other names
Internal Medicine Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. DOMINIC JACKSON MEMORIAL HOSPITAL
Authorized official
DANIELLE STUART (CREDENTIALING SPECIALIST)
(601) 200-4880
Entity
Organization
Contact information
Practice address
971 LAKELAND DR, SUITE 250, JACKSON, MS 39216-4643
(601) 982-1283
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-5986
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
MS
Other
Enumeration date
05/12/2009
Last updated
07/22/2019
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