Stork, Jerry Lee

Stork, Jerry Lee is an individual health care provider with primary practice located at 3688 Veterans Memorial Dr 200, Hattiesburg MS 39401-8246. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Stork, Jerry Lee can be contacted via phone (601) 554-7402.

Contact Information

Primary practice address
3688 Veterans Memorial Dr 200 Hattiesburg MS 39401-8246
Phone: (601) 554-7402
Fax: (601) 554-7488
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9103513 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00079 Mississippi

Profile Details

NPI number 1467479550
LBN Legal business name Stork, Jerry Lee
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated Oct 19th, 2021 - about 5 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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