Organization
ST DOMINIC MEDICAL ASSOCIATES LLC
Active
Parent organization
ST DOMINIC JACKSON MEMORIAL HOSPITAL
Other names
St Dominic Pain Management Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST DOMINIC JACKSON MEMORIAL HOSPITAL
Authorized official
JENNIFER SINCLAIR (PRESIDENT OF SDMA)
(601) 200-2000
Entity
Organization
Contact information
Practice address
970 LAKELAND DR, SUITE 45, JACKSON, MS 39216-4635
(601) 200-4690
(601) 200-4698
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08009242
—
MS
Enumeration date
08/29/2013
Last updated
02/04/2015
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