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Individual

DR. ERIC J PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
730 W MARKET STREET, LIMA, OH 45801
(419) 227-3361
Mailing address
PO BOX 71-0776, COLUMBUS, OH 43271-0776
(419) 228-1506
(419) 228-3352

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35056347P
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000141855
ANTHEM
OH
05
2136978
OH
01
27156843500
WORKERS COMPENSATION
OH
Enumeration date
08/04/2006
Last updated
07/08/2007
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