DALLAS LEE DOMANGUE

JACKSON, MS
NPI1205413010
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: MS  T-4248)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-03-26
Last Update Date2021-07-03
Business Address
DALLAS LEE DOMANGUE MD
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-1000
Mailing Address
DALLAS LEE DOMANGUE MD
127 PARKWAY DR APT 1103
JACKSON, MS 39211-4212
Phone number: 985-860-6961