<Unavail>

LBN: St. Dominic Jackson Memorial
<Unavail> is an health care organization with primary practice located at 969 Lakeland Dr , Jackson MS 39216-4606. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Surgery, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant. Allopathic & Osteopathic Physicians / Emergency Medicine is the primary health care specialty. St. Dominic Jackson Memorial can be contacted via phone (601) 200-2000, or through Hatten, Karl via phone (601) 200-2000.

Contact Information

Primary practice address
969 Lakeland Dr Jackson MS 39216-4606
Phone: (601) 200-2000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Hatten, Karl Doctor of Medicine (MD)
Phone: (601) 200-2000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X Mississippi
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X Mississippi
Allopathic & Osteopathic Physicians / Surgery 208600000X Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X Mississippi

Profile Details

NPI number 1235173691
LBN Legal business name St. Dominic Jackson Memorial
DBA Doing business as <Unavail>
Authorized official Hatten, Karl Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 16th, 2006
Last updated Aug 11th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235173691 NPPES
Mississippi MEDICAID 09014778

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