Organization · Type 2 NPI

ST Dominic Medical Associates

Gynecologic Oncology Physician · Jackson, MS

NPI number 1346510559 Active

Practice location

971 Lakeland Dr, Suite 750
Jackson, MS 39216-4643

Call (601) 200-4970 Map

Fax (601) 200-5943

Mailing address

PO Box 23666
Jackson, MS 39225-3666

Specialties and licenses

Taxonomy	Code	License
Gynecologic Oncology Physician Primary	207VX0201X	None listed

Gynecologic Oncology Physician: An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.

113 other providers at this address

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NPI record

NPI: 1346510559
Entity type: Organization (Type 2)
Issued: Jan 4, 2012
Last updated: Mar 16, 2021
Status: Active
Subpart: Yes of ST Dominic Jackson Memorial Hospital

Other names

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ST Dominic's Gynecologic Oncology · doing business as
ST Dominic's Gynecologic Oncology · doing business as

Authorized official

Danielle Stuart
Credentialing Specialist
(601) 200-4880

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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 1346510559

ST Dominic Medical Associates's National Provider Identifier is 1346510559, issued on Jan 4, 2012. The primary taxonomy on file is Gynecologic Oncology Physician (207VX0201X), and the practice location is in Jackson, MS. The record was last updated on Mar 16, 2021.