Gross, Jerry Lee

Gross, Jerry Lee is an individual health care provider with primary practice located at 247 Shiloh Rd , Forest City NC 28043-6958. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Gross, Jerry Lee can be contacted via phone (828) 245-6405.

Contact Information

Primary practice address
247 Shiloh Rd Forest City NC 28043-6958
Phone: (828) 245-6405
Fax: (828) 245-3923
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 422 North Carolina

Profile Details

NPI number 1134149628
LBN Legal business name Gross, Jerry Lee
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Apr 2nd, 2008 - about 16 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 1134149628 NPPES
North Carolina MEDICAID 790800J

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