Organization
ST. DOMINIC MEDICAL ASSOCIATES LLC
Active
Parent organization
ST. DOMINIC-JACKSON MEMORIAL HOSPITAL
Other names
St. Dominic Gastroenterology
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. DOMINIC-JACKSON MEMORIAL HOSPITAL
Authorized official
DANIELLE STUART (CREDENTIALING SPECIALIST)
(601) 200-4880
Entity
Organization
Contact information
Practice address
971 LAKELAND DR STE 250, JACKSON, MS 39216-4620
(601) 200-5550
(601) 200-4887
Mailing address
971 LAKELAND DR STE 250, JACKSON, MS 39216-4620
(601) 200-5550
(601) 200-4887
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
12/22/2022
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