MEDICARE: ANTONY PORTER

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1073471116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONY PORTER

Provider Business Mailing Address
First Line	:	5130 SEDALIA DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-6341
Country	:	US
Telephone Number	:	614-806-6211
Fax Number	:

Provider Business Practice Location Address
First Line	:	5130 SEDALIA DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-6341
Country	:	US
Telephone Number	:	614-806-6211
Fax Number	:

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

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Directions to “ ANTONY PORTER ” Practice Location

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