Organization
ST DOMINIC MEDICAL ASSOCIATES LLC
Active
Parent organization
ST DOMINIC JACKSON MEMORIAL HOSPITAL
Other names
St Dominic Surgical Oncology
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST DOMINIC JACKSON MEMORIAL HOSPITAL
Authorized official
JENNIFER SINCLAIR (PRESIDENT OF SDMA)
(601) 200-6955
Entity
Organization
Contact information
Practice address
106 HIGHLAND WAY, STE 200, MADISON, MS 39110-6929
(601) 200-7465
(601) 200-5929
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
14863
MS
2086X0206X
Surgical Oncology Physician
14786
MS
Other
Enumeration date
02/07/2014
Last updated
02/13/2014
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