St. Dominic Jackson Memorial in Jackson - Anesthesiologist Assistant
St. Dominic Jackson Memorial - NPI 1235173691
St. Dominic Jackson Memorial is a Anesthesiologist Assistant in Jackson, Mississippi. St. Dominic Jackson Memorial practices all healthcare services and medical treatments related to Anesthesiologist Assistant. The NPI Number for St. Dominic Jackson Memorial is 1235173691. The last update date is 2010-08-11.
St. Dominic Jackson Memorial's current location address is 969 Lakeland Dr, Jackson, Mississippi. You can contact this provider via phone number 6012002000. The mailing address for St. Dominic Jackson Memorial is 969 Lakeland Dr, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
Provider Organization | St. Dominic Jackson Memorial |
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Address | 969 Lakeland Dr, Jackson, Mississippi |
Phone Number | 6012002000 |
Fax Number | |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | DIRECTOR |
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Authorized Official Name | Hatten Karl |
Credentials | M.D. |
Telephone Number | 6012002000 |
NPI Number Detail
NPI Number | 1235173691 |
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Provider Enumeration Date | 2006-06-16 |
Last Updated Date | 2010-08-11 |
Provider Mailing Address Detail
Address | 969 Lakeland Dr |
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City | Jackson |
State | Mississippi (MS) |
Post Code | 392164606 |
Phone Number | 6012002000 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Anesthesiologist Assistant |
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Taxonomy | 367H00000X |
Definition: An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesth |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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9014778 | MS | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to St. Dominic Jackson Memorial?
The St. Dominic Jackson Memorial has been issued the NPI (National Provider Identifier) 1235173691 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete physical address where St. Dominic Jackson Memorial is located?
The St. Dominic Jackson Memorial is situated at the following address: 969 Lakeland Dr, Jackson, MS, 392164606.
What is St. Dominic Jackson Memorial's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for St. Dominic Jackson Memorial is Anesthesiologist Assistant, and the taxonomy classification code that categorizes this area of expertise is 367H00000X.
On what date did the St. Dominic Jackson Memorial receive the assignment of its 1235173691 from the Centers for Medicare & Medicaid Services?
The St. Dominic Jackson Memorial was issued its 1235173691 by the Centers for Medicare & Medicaid Services on 2006-06-16.
When was the information pertaining to St. Dominic Jackson Memorial most recently updated or revised?
The details related to St. Dominic Jackson Memorial, including its address, specialty, and other relevant information, were last updated or revised on 2010-08-11.
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