St. Dominic Medical Associates LLC
NPI #1245393255 in Madison, Mississippi
Provider Information
- NPI Number
- 1245393255
- Entity Type
- Organization
- Organization Name
- St. Dominic Medical Associates LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Dec 19, 2006
- Last Updated
- Aug 31, 2018
Practice Location
- Address
- 106 HIGHLAND WAY
- Address 2
- SUITE 103
- City
- Madison
- State
- Mississippi
- ZIP Code
- 39110-6929
- Phone
- (601) 200-4750
Authorized Official
- Name
- DANIELLE STUART
- Title
- CREDENTIALING SPECIALIST
- Phone
- (601) 200-4880
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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