NPI Provider: 1255303517
Contact Name: Yelverton Richard
Position: Medical Director
Phone: (601) 984-8800
St. Dominic Ambulatory Surgery Center Information:
St. Dominic Ambulatory Surgery Center organization have npi 1255303517, taxonomy code is 261QA1903X with license number is 11 in . This Business address located in 970 Lakeland Dr., Jakcson, MS 39216 Mississippi.
Practice Location
Address: 970 Lakeland Dr, Jackson, MS 39216
Phone: (601) 984-8800
Business Location
Address: 970 Lakeland Dr., Jakcson, MS 39216
Phone: (601) 984-8800
Fax: (601) 321-8670
Taxonomy
Taxonomy Code: 261QA1903X
License Number: 11
License Number of State: MS
Primary Taxonomy Switch: Y
Enumeration Date: 2/2/2006
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