St Dominic Ambulatory Surgery Center L L C
NPI #1255303517 in Jackson, Mississippi
Provider Information
- NPI Number
- 1255303517
- Entity Type
- Organization
- Organization Name
- St Dominic Ambulatory Surgery Center L L C
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Feb 2, 2006
- Last Updated
- Jun 16, 2010
Practice Location
- Address
- 970 LAKELAND DR
- Address 2
- SUITE 15
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39216-4601
- Phone
- (601) 984-8800
Authorized Official
- Name
- DR. RICHARD YELVERTON, M.D.
- Title
- MEDICAL DIRECTOR
- Phone
- (601) 984-8800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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