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Organization

ST DOMINIC MEDICAL ASSOCIATES LLC

Active
Parent organization
ST DOMINIC JACKSON MEMORIAL HOSPITAL
Other names
St Dominic Family Practice Brandon
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
1297 WEST GOVERNMENT STREET, BRANDON, MS 39042
(601) 200-4790
(601) 200-4855
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18818
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02751790
MS
Enumeration date
10/28/2013
Last updated
12/30/2016
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