Keith Porter, | |
391 Southcrest Cir Ste 108, Southaven, MS 38671-4775 | |
(662) 349-2659 | |
Not Available |
Full Name | Keith Porter |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Experience | 10 Years |
Location | 391 Southcrest Cir Ste 108, Southaven, Mississippi |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376923649 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 26479 (Mississippi) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Jackson-madison County General Hospital | Jackson, TN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Medical Center Anesthesia, Inc | 2769629187 | 83 |
Entity Name | Medical Center Anesthesia, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447591730 PECOS PAC ID: 2769629187 Enrollment ID: O20130502000265 |
Mailing Address | Practice Location Address |
---|---|
Keith Porter, 391 Southcrest Cir Ste 108, Southaven, MS 38671-4775 Ph: (901) 830-4211 | Keith Porter, 391 Southcrest Cir Ste 108, Southaven, MS 38671-4775 Ph: (662) 349-2659 |
Sandra Joann Reed, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 7601 Southcrest Pkwy, Southaven, MS 38671 Phone: 334-386-2053 Fax: 334-244-1830 | |
Rodney D. Rothstein, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 7601 Southcrest Pkwy, Southaven, MS 38671 Phone: 334-386-2053 Fax: 334-244-1830 | |
Jovie N. Bridgewater, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 7601 Southcrest Pkwy, Southaven, MS 38671 Phone: 662-349-4000 Fax: 334-244-1830 |