| John K.L. Porter, D.O., PC | |
|
4749 Berry Blvd Montgomery AL 36106-3079 | |
| (334) 579-3498 | |
| (334) 888-8611 |
| Full Name | John K.L. Porter, D.O., PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 4749 Berry Blvd, Montgomery, Alabama |
| Authorized Official Name and Position | John K Porter (D.O./OWNER) |
| Authorized Official Contact | 3342658455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John K.L. Porter, D.O., PC 4749 Berry Blvd Montgomery AL 36106-3079 Ph: (334) 579-3498 | John K.L. Porter, D.O., PC 4749 Berry Blvd Montgomery AL 36106-3079 Ph: (334) 579-3498 |
| NPI Number | 1083096747 |
|---|---|
| Provider Enumeration Date | 06/18/2015 |
| Last Update Date | 07/28/2026 |
| Certification Date | 07/28/2026 |
| Medicare PECOS PAC ID | 3971818758 |
|---|---|
| Medicare Enrollment ID | O20150824000929 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083096747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 1488 (Alabama) | Primary |
| Provider Name | John Porter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205182508 PECOS PAC ID: 0648404129 Enrollment ID: I20150826000598 |
| Provider Name | Brooke Ross Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043742489 PECOS PAC ID: 6507017258 Enrollment ID: I20171009000109 |
| Provider Name | Zane P Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043787526 PECOS PAC ID: 5395089064 Enrollment ID: I20181206001525 |
| Provider Name | Emily Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528467701 PECOS PAC ID: 1557792710 Enrollment ID: I20200504001932 |
| Provider Name | Reagan L Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659077709 PECOS PAC ID: 3274999545 Enrollment ID: I20230512000569 |
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