Organization
ST DOMINIC MEDICAL ASSOCIATES LLC
Active
Parent organization
ST DOMINIC JACKSON MEMORIAL HOSPITAL
Other names
Ear Nose and Throat Surgical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST DOMINIC JACKSON MEMORIAL HOSPITAL
Authorized official
MS. JENNIFER SINCLAIR (VICE PRESIDENT OF FINANCE)
(601) 200-2000
Entity
Organization
Contact information
Practice address
970 LAKELAND DR, SUITE 40, JACKSON, MS 39216-4635
(601) 200-4850
(601) 200-4838
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
MS
Other
Enumeration date
05/06/2009
Last updated
12/18/2013
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