Sturdivant, Grace Gore

Sturdivant, Grace Gore is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Sturdivant, Grace Gore can be contacted via phone (601) 815-6000.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 815-6000
Fax: (601) 984-5085
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X A3608 Mississippi

Profile Details

NPI number 1558636282
LBN Legal business name Sturdivant, Grace Gore
Credentials AU.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 13th, 2012
Last updated Mar 17th, 2014 - about 12 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 1558636282 NPPES
Mississippi MEDICAID 07203769
Mississippi Other P01266932

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