Provider Demographics
NPI:1275647794
Name:GORR, JESSICA H (DO)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:H
Last Name:GORR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:135 E RICH BLVD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-5518
Mailing Address - Country:US
Mailing Address - Phone:252-333-1277
Mailing Address - Fax:252-333-1877
Practice Address - Street 1:135 E RICH BLVD
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-5518
Practice Address - Country:US
Practice Address - Phone:252-333-1277
Practice Address - Fax:252-333-1877
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01384208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC144RNOtherBC BS NC
NC5905312Medicaid
NC144RNOtherBC BS NC
NC5905312Medicaid