Provider Demographics
NPI:1003287103
Name:HUNG, JESSICA LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LEE
Last Name:HUNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WESLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5135
Mailing Address - Country:US
Mailing Address - Phone:985-507-8688
Mailing Address - Fax:
Practice Address - Street 1:4154 WULFF RD E STE E
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-5287
Practice Address - Country:US
Practice Address - Phone:251-645-7979
Practice Address - Fax:251-645-9008
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist