St. Dominic Family Practice Associates-Jackson

LBN: St Dominic Medical Associates Llc
St. Dominic Family Practice Associates-Jackson is an health care organization with primary practice located at 890 Lakeland Dr , Jackson MS 39216-4644. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as the primary health care specialty. St Dominic Medical Associates Llc can be contacted via phone (601) 200-3131, or through Stuart, Danielle via phone (601) 200-4880.

Contact Information

Primary practice address
890 Lakeland Dr Jackson MS 39216-4644
Phone: (601) 200-3131
Fax: (601) 200-5929
Website:
Map and Directions
Authorized official contact:
Name: Stuart, Danielle
Phone: (601) 200-4880

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R886071 Mississippi

Profile Details

NPI number 1508263179
LBN Legal business name St Dominic Medical Associates Llc
DBA Doing business as St. Dominic Family Practice Associates-Jackson
Authorized official Stuart, Danielle
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 26th, 2014
Last updated Oct 18th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508263179 NPPES
Mississippi MEDICAID 04838265

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