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

St Dominic Medical Associates LLC

Organization Family Medicine Physician · NPI 1407920549

St Dominic Medical Associates LLC is a Family Medicine Physician in Jackson, Mississippi. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
10
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

969 Lakeland Dr
Jackson, MS 39216-4606
Phone: (601) 200-4749
Fax: (601) 200-5929
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Neurological Surgery Physician Taxonomy 207T00000X
Gynecologic Oncology Physician Taxonomy 207VX0201X
Otolaryngology Physician Taxonomy 207Y00000X
Neurology Physician Taxonomy 2084N0400X
Psychiatry Physician Taxonomy 2084P0800X
Surgical Critical Care Physician Taxonomy 2086S0102X
Urology Physician Taxonomy 208800000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X
Pain Medicine Physician Taxonomy 208VP0000X

Record details

NPI number1407920549
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSt Dominc Jackson Memorial Hospital
Authorized official Danielle Stuart — Credentialing Specialist · (601) 200-4880
NPI enumeratedNovember 20, 2006
Last updated in NPPESNovember 18, 2021
Certification dateNovember 18, 2021
Mailing addressPo Box 23666, Jackson, MS 39225-3666

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