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NPI Code Detail

MEDICARE: JOLIE GARCIA PORTER MD

MEDICARE: JOLIE GARCIA PORTER MD
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
1207R00000XInternal Medicine Physician27601TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P01213528OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14342199OTHERTNBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760476824
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOLIE GARCIA PORTER MD
Provider Business Mailing Address
First Line : 1211 UNION AVE STE 330
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-6655
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7690 WOLF RIVER CIR
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-1744
Country : US
Telephone Number : 901-756-1231
Fax Number : 901-791-9495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2005
Last Update Date : 05/20/2025

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Directions to “ JOLIE GARCIA PORTER MD” Practice Location

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