# JOHN C. PORTER MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457581795
- **Authorized official:** DR. JOHN C PORTER MD (PRESIDENT)
- **Authorized official phone:** (623) 764-8074

## Contact information

- **Practice address:** 12238 N 45TH LN, GLENDALE, AZ 85304-2312
- **Practice address phone:** (623) 764-8074
- **Practice address fax:** (623) 878-8712
- **Mailing address:** PO BOX 5415, GLENDALE, AZ 85312-5415
- **Mailing address phone:** (623) 764-8074
- **Mailing address fax:** (623) 878-8712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | 15286 | AZ | Yes |

## Other

- **Enumeration date:** 07/21/2009
- **Last updated:** 07/21/2009