Provider Demographics
NPI:1417237603
Name:JOEL PORTER, M.D., L.L.C.
Entity Type:Organization
Organization Name:JOEL PORTER, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-429-1415
Mailing Address - Street 1:1 MILLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2714
Mailing Address - Country:US
Mailing Address - Phone:856-429-1415
Mailing Address - Fax:
Practice Address - Street 1:6981 N PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-4201
Practice Address - Country:US
Practice Address - Phone:856-488-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty