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Organization

ST. DOMINIC MEDICAL ASSOCIATES LLC

Active
Other names
Neurosurgery Associates
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER SINCLAIR (PRESIDENT OF SDMA)
(601) 200-6955
Entity
Organization

Contact information

Practice address
971 LAKELAND DR. SUITE 1250, JACKSON, MS 39216-0000
(601) 200-5955
(601) 200-5943
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01600341
MS
Enumeration date
12/19/2006
Last updated
06/28/2016
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