MEDICARE: MR. JAMES WILLIAM PORTIER CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1699875856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES WILLIAM PORTIER CRNA

Provider Business Mailing Address
First Line	:	PO BOX 9934
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36691-0934
Country	:	US
Telephone Number	:	251-490-8039
Fax Number	:

Provider Business Practice Location Address
First Line	:	2451 FILLINGIM ST
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36617-2238
Country	:	US
Telephone Number	:	251-471-7035
Fax Number	:	251-471-7042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	04/12/2026

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