Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

St Dominic Jackson Memorial

Organization Anesthesiology Physician · NPI 1235173691

St Dominic Jackson Memorial is an Anesthesiology Physician in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
Specialties on file
5

Practice location Address checks out

969 Lakeland Dr
Jackson, MS 39216-4606
Phone: (601) 200-2000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X (MS)
Anesthesiology Physician Taxonomy 207L00000X (MS)
Surgery Physician Taxonomy 208600000X (MS)
Certified Registered Nurse Anesthetist Taxonomy 367500000X (MS)
Anesthesiologist Assistant Taxonomy 367H00000X (MS)

Record details

NPI number1235173691
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Karl Hatten — Director · (601) 200-2000
Other names St Dominic Emergency Room
NPI enumeratedJune 16, 2006
Last updated in NPPESAugust 11, 2010
Mailing address969 Lakeland Dr, Jackson, MS 39216-4606

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