Provider Demographics
NPI:1508890286
Name:PORTER, LESTER L (MD)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:L
Last Name:PORTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 440100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0100
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:
Practice Address - Street 1:4220 HARDING PIKE
Practice Address - Street 2:S& E BUILDING SUITE 200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2005
Practice Address - Country:US
Practice Address - Phone:615-385-3751
Practice Address - Fax:615-269-7085
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN11294207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3151471OtherBCBS OF TN
KY64776867Medicaid
900003212OtherRAILROAD MEDICARE
TN3185115Medicaid
4066773OtherAETNA
4066773OtherAETNA
B59457Medicare UPIN