JERRY STORK, P.A.
Physician Assistant
Active
Individual
NPI: 1467479550
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant - Medical | 363AM0700X | No | PA9103513 (FL) |
| Physician Assistant | 363A00000X | Yes | PA00079 (MS) |
Frequently Asked Questions
NPI 1467479550 is the National Provider Identifier for JERRY STORK, P.A., a Physician Assistant provider located in Hattiesburg, MS. This NPI was enumerated on July 16, 2006.
JERRY STORK, P.A. practices at 3688 VETERANS MEMORIAL DR, 200, Hattiesburg, MS 39401.
Quick Facts
- NPI
- 1467479550
- Type
- Individual
- Enumerated
- Jul 16, 2006
- Last Updated
- Oct 19, 2021
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