St. Dominic Medical Associates LLC

NPI #1124252788 in Jackson, Mississippi

Provider Information

NPI Number
1124252788
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
Internal Medicine
Enumeration Date
May 12, 2009
Last Updated
Jul 22, 2019

Practice Location

Address
971 LAKELAND DR
Address 2
SUITE 250
ZIP Code
39216-4643
Phone
(601) 982-1283

Authorized Official

Name
DANIELLE STUART
Title
CREDENTIALING SPECIALIST
Phone
(601) 200-4880

Specialties & Taxonomy Codes

Specialty
Internal Medicine

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