St Dominic Medical Associates Llc in Jackson - Clinical
St Dominic Medical Associates Llc - NPI 1386708188
St Dominic Medical Associates Llc is a Clinical in Jackson, Mississippi. St Dominic Medical Associates Llc practices all healthcare services and medical treatments related to Clinical. The NPI Number for St Dominic Medical Associates Llc is 1386708188. The last update date is 2021-08-11.
St Dominic Medical Associates Llc's current location address is 969 Lakeland Dr, Jackson, Mississippi. You can contact this provider via phone number 6012003110 and fax number 6012003109. The mailing address for St Dominic Medical Associates Llc is 969 Lakeland Dr, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | St Dominic Medical Associates Llc |
|---|---|
| Address | 969 Lakeland Dr, Jackson, Mississippi |
| Phone Number | 6012003110 |
| Fax Number | 6012003109 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CREDENTIAL |
|---|---|
| Authorized Official Name | Stuart Danielle |
| Telephone Number | 6012004880 |
NPI Number Detail
| NPI Number | 1386708188 |
|---|---|
| Provider Enumeration Date | 2006-12-19 |
| Last Updated Date | 2021-08-11 |
Provider Mailing Address Detail
| Address | 969 Lakeland Dr |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 392164606 |
| Phone Number | 6012003110 |
| Fax Number | 6012003109 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 784213 | MS | -- |
Post Comment/ Review Below
What is the unique identification code assigned to St Dominic Medical Associates Llc by the Centers for Medicare & Medicaid Services?
The St Dominic Medical Associates Llc has been issued the NPI (National Provider Identifier) 1386708188. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where St Dominic Medical Associates Llc is physically located?
The St Dominic Medical Associates Llc is physically situated at the following address: 969 Lakeland Dr, Jackson, MS, 392164606.
What is St Dominic Medical Associates Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The St Dominic Medical Associates Llc's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1386708188 to St Dominic Medical Associates Llc?
The St Dominic Medical Associates Llc received its 1386708188 assignment from the Centers for Medicare & Medicaid Services on 2006-12-19.
As of what date was the information pertaining to St Dominic Medical Associates Llc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to St Dominic Medical Associates Llc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2021-08-11.
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