Provider Demographics
NPI:1780203893
Name:PORTER, JAMES HAYWARD (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HAYWARD
Last Name:PORTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-4999
Mailing Address - Country:US
Mailing Address - Phone:603-543-6951
Mailing Address - Fax:603-543-6950
Practice Address - Street 1:243 ELM ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-4999
Practice Address - Country:US
Practice Address - Phone:603-543-6951
Practice Address - Fax:603-543-6950
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMT220340207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program