| Mrs Marlee Hope Domangue, | |
|
971 Lakeland Dr Ste 750, Jackson, MS 39216-4608 | |
| (601) 200-4970 | |
| Not Available |
| Full Name | Mrs Marlee Hope Domangue |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 2 Years |
| Location | 971 Lakeland Dr Ste 750, Jackson, Mississippi |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962230425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (NU) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fmol Health I St Dominic | Jackson, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St. Dominic Medical Associates Llc | 0446303168 | 130 |
| Entity Name | St. Dominic Medical Associates LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407920549 PECOS PAC ID: 0446303168 Enrollment ID: O20090728000821 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Marlee Hope Domangue, 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (601) 200-4970 | Mrs Marlee Hope Domangue, 971 Lakeland Dr Ste 750, Jackson, MS 39216-4608 Ph: (601) 200-4970 |
Kimberly M Cook, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-815-1312 |
Amber Goodman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 970 Lakeland Dr Ste 61, Jackson, MS 39216 Phone: 601-982-7850 Fax: 601-366-8507 |
Stephanie Keith, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1659 Lelia Dr, Jackson, MS 39216 Phone: 601-910-3004 Fax: 601-910-3005 |
David Andrew Porter, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-1000 |
Kelsey A North, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Dr Ste 1460, Jackson, MS 39216 Phone: 513-708-4211 |
Mary Allison Durr, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1325 E Fortification St, Jackson, MS 39202 Phone: 601-354-4488 Fax: 601-914-1835 |
Sarah Joanna Mason, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7275 S Siwell Rd, Jackson, MS 39272 Phone: 601-373-7722 Fax: 601-373-7128 |