| NPI | 1245393255 |
|---|---|
| Doing Business As | ST DOMINIC FAMILY PRACTICE ASSOCIATES MADISON |
| Doing Business As | ST DOMINIC FAMILY PRACTICE ASSOCIATES GLUCKSTADT |
| Entity Type | Organization |
| Authorized Contact | DANIELLE STUART Credentialing Specialist 601-200-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2018-08-31 |