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General NPI Number Information
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NPI Number | 1689105652
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Entity Type | Individual
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Provider Name | LOUIS BASSETT PORTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | UVMMC 111 COLCHESTER AVENUE
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City | BURLINGTON
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State | VT
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Zip | 05401
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Country | US
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Telephone | 802-847-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 255 QUARRY HILL RD APT 141
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-6397
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Country | US
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Telephone | 801-706-7305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD201292
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 042.0014621
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License Number State | VT
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