Individual
DOMINIC ARTHUR JAEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 CROSSGATES BLVD, BRANDON, MS 39042-2601
(601) 664-1361
Mailing address
350 CROSSGATES BLVD, BRANDON, MS 39042-2601
(601) 644-1361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18275
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03281556
—
MS
01
—
P01184541
RR MEDICARE
MS
Enumeration date
11/13/2006
Last updated
01/09/2024
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