John K.l. Porter, D.o., Pc | |
1758 Park Pl Ste 100b Montgomery AL 36106-1133 | |
(334) 265-8455 | |
(334) 265-8456 |
Full Name | John K.l. Porter, D.o., Pc |
---|---|
Speciality | Internal Medicine |
Location | 1758 Park Pl Ste 100b, Montgomery, Alabama |
Authorized Official Name and Position | John K Porter (D.O./OWNER) |
Authorized Official Contact | 3342658455 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
John K.l. Porter, D.o., Pc 1758 Park Pl Ste 100b Montgomery AL 36106-1133 Ph: (334) 265-8455 | John K.l. Porter, D.o., Pc 1758 Park Pl Ste 100b Montgomery AL 36106-1133 Ph: (334) 265-8455 |
NPI Number | 1083096747 |
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Provider Enumeration Date | 06/18/2015 |
Last Update Date | 05/30/2024 |
Medicare PECOS PAC ID | 3971818758 |
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Medicare Enrollment ID | O20150824000929 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083096747 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 1488 (Alabama) | Primary |
Provider Name | John Porter |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1205182508 PECOS PAC ID: 0648404129 Enrollment ID: I20150826000598 |
Provider Name | Emily Harris |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528467701 PECOS PAC ID: 1557792710 Enrollment ID: I20200504001932 |
Provider Name | Matthew J Delk |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194324426 PECOS PAC ID: 5799154092 Enrollment ID: I20221208001252 |
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