St Dominic Medical Associates LLC
NPI #1083032171 in Raleigh, Mississippi
Provider Information
- NPI Number
- 1083032171
- Entity Type
- Organization
- Organization Name
- St Dominic Medical Associates LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- ST DOMINIC JACKSON MEMORIAL HOSPITAL
- Primary Specialty
- Family Medicine
- Enumeration Date
- Apr 4, 2014
- Last Updated
- Jul 2, 2019
Practice Location
- Address
- 342 MAGNOLIA DR
- City
- Raleigh
- State
- Mississippi
- ZIP Code
- 39153-6012
- Phone
- (601) 200-6809
Authorized Official
- Name
- DANIELLE STUART
- Title
- CREDENTIALING SPECIALIST
- Phone
- (601) 200-4880
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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