Provider Demographics
NPI:1710283098
Name:STORY, JAMES LLEWELLYN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LLEWELLYN
Last Name:STORY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 SADDLEBROOK PLANTATION
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31757-1762
Mailing Address - Country:US
Mailing Address - Phone:229-226-0022
Mailing Address - Fax:
Practice Address - Street 1:262 SADDLEBROOK PLANTATION
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31757-1762
Practice Address - Country:US
Practice Address - Phone:229-226-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011074208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery