| John K.l. Porter, D.o., Pc | |
|
1758 Park Pl Ste 100b Montgomery AL 36106-1133 | |
| (334) 265-8455 | |
| (334) 265-8456 |
| Full Name | John K.l. Porter, D.o., Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1758 Park Pl Ste 100b, 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 Po Box 242848 Montgomery AL 36124-2848 Ph: (334) 386-9357 | John K.l. Porter, D.o., Pc 1758 Park Pl Ste 100b Montgomery AL 36106-1133 Ph: (334) 265-8455 |
| NPI Number | 1083096747 |
|---|---|
| Provider Enumeration Date | 06/18/2015 |
| Last Update Date | 03/17/2018 |
| 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 | Emily Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528467701 PECOS PAC ID: 1557792710 Enrollment ID: I20200504001932 |
| Provider Name | Matthew J Delk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194324426 PECOS PAC ID: 5799154092 Enrollment ID: I20221208001252 |
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