Provider Demographics
NPI:1306910963
Name:STORER, JAMES S (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:STORER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:111 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:MS
Mailing Address - Zip Code:39652-2825
Mailing Address - Country:US
Mailing Address - Phone:601-783-2374
Mailing Address - Fax:601-783-5126
Practice Address - Street 1:111 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:MS
Practice Address - Zip Code:39652-2825
Practice Address - Country:US
Practice Address - Phone:601-783-2374
Practice Address - Fax:601-783-5126
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS10576207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology