Organization · Type 2 NPI

ST Dominic Medical Associates LLC

Family Medicine Physician · Brandon, MS

NPI number 1548698608 Active

Practice location

1297 West Government Street
Brandon, MS 39042

Call (601) 200-4790 Map

Fax (601) 200-4855

Mailing address

PO Box 23666
Jackson, MS 39225-3666

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	18818 (MS)

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: 1548698608
Entity type: Organization (Type 2)
Issued: Oct 28, 2013
Last updated: Dec 30, 2016
Status: Active
Subpart: Yes of ST Dominic Jackson Memorial Hospital

Other names

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ST Dominic Family Practice Brandon · doing business as

Authorized official

Jennifer Sinclair
President of Sdma
(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 1548698608

ST Dominic Medical Associates LLC's National Provider Identifier is 1548698608, issued on Oct 28, 2013. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Brandon, MS. The record was last updated on Dec 30, 2016.