Gorrell, Stephanie

Gorrell, Stephanie is an individual health care provider with primary practice located at 1325 E Fortification St , Jackson MS 39202-2442. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Gorrell, Stephanie can be contacted via phone (601) 949-9110.

Contact Information

Primary practice address
1325 E Fortification St Jackson MS 39202-2442
Phone: (601) 949-9110
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X PT3169 Mississippi

Profile Details

NPI number 1992725444
LBN Legal business name Gorrell, Stephanie
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992725444 NPPES
Mississippi MEDICAID 07071069

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