Organization · Type 2 NPI

ST Dominic Medical Associates LLC

Family Medicine Physician · Jackson, MS

NPI number 1093032849 Active

Practice location

969 Lakeland Dr St Thomas Hall
Jackson, MS 39216-4606

Call (601) 200-3110 Map

Fax (601) 200-3109

Mailing address

PO Box 23666
Jackson, MS 39225-3666

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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NPI record

NPI: 1093032849
Entity type: Organization (Type 2)
Issued: May 3, 2010
Last updated: Dec 20, 2013
Status: Active
Subpart: Yes of ST Dominic Jackson Memorial Hospital

Other names

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Chronic Care Clinic · doing business as

Authorized official

Jennifer Sinclair
Chief Financial Officer
(601) 200-2000

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1093032849

ST Dominic Medical Associates LLC's National Provider Identifier is 1093032849, issued on May 3, 2010. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Jackson, MS. The record was last updated on Dec 20, 2013.