NPI 1902374085 · live from the CMS NPI Registry
St. Dominic Medical Associates LLC
Internal Medicine, Gastroenterology in Jackson, MS. National Provider Identifier 1902374085, active.
NPI record
| NPI | 1902374085 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Gastroenterology 207RG0100X |
| Practice location | 971 Lakeland Dr Ste 250, Jackson, MS 39216 |
| Practice phone | 601-200-5550 |
| Enumerated | November 7, 2018 |
| Last updated | December 22, 2022 |
| Authorized official | Danielle Stuart, Credentialing Specialist |
| Other names | St. Dominic Gastroenterology |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Gastroenterology primary | 207RG0100X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.