Healthcare Provider Details

I. General information

NPI: 1417073198
Provider Name (Legal Business Name): JOHN A PORTER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1758 PARK PL SUITE 406
MONTGOMERY AL
36106-1127
US

IV. Provider business mailing address

1758 PARK PL SUITE 406
MONTGOMERY AL
36106-1127
US

V. Phone/Fax

Practice location:
  • Phone: 334-284-1500
  • Fax: 334-288-7763
Mailing address:
  • Phone: 334-284-1500
  • Fax: 334-288-7763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN ARTHUR PORTER
Title or Position: OWNER
Credential: M.D.
Phone: 334-284-1500