Provider Demographics
NPI:1508029117
Name:DR. ANTHONY F. PORTO, JR.
Entity Type:Organization
Organization Name:DR. ANTHONY F. PORTO, JR.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUARNSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-941-6122
Mailing Address - Street 1:1010 CARONDELET DR
Mailing Address - Street 2:SUITE #121
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4859
Mailing Address - Country:US
Mailing Address - Phone:816-941-6122
Mailing Address - Fax:816-941-0880
Practice Address - Street 1:1010 CARONDELET DR
Practice Address - Street 2:SUITE #121
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114
Practice Address - Country:US
Practice Address - Phone:816-941-6122
Practice Address - Fax:816-941-0880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6842207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0005274CMedicare PIN