Provider Demographics
NPI:1417073198
Name:JOHN A PORTER MD PC
Entity Type:Organization
Organization Name:JOHN A PORTER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-284-1500
Mailing Address - Street 1:1758 PARK PL
Mailing Address - Street 2:SUITE 406
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1127
Mailing Address - Country:US
Mailing Address - Phone:334-284-1500
Mailing Address - Fax:334-288-7763
Practice Address - Street 1:1758 PARK PL
Practice Address - Street 2:SUITE 406
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1127
Practice Address - Country:US
Practice Address - Phone:334-284-1500
Practice Address - Fax:334-288-7763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC74958Medicare UPIN