Organization
ST. DOMINIC MEDICAL ASSOCIATES INC
Active
Parent organization
ST. DOMINIC JACKSON MEMORIAL HOSPITAL
Other names
Cardiovascular Surgery Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. DOMINIC JACKSON MEMORIAL HOSPITAL
Authorized official
JENNIFER SINCLAIR (VICE PRESIDENT OF FINANCE)
(601) 200-2000
Entity
Organization
Contact information
Practice address
971 LAKELAND DR, SUITE 1159, JACKSON, MS 39216-4643
(601) 200-2000
Mailing address
971 LAKELAND DR, SUITE 1159, JACKSON, MS 39216-4643
(601) 200-2000
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00978789
—
MS
Enumeration date
06/11/2009
Last updated
06/11/2009
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