Individual
DAVID ANDREW PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
577 OLD HIGHWAY 84 RD, WAYNESBORO, MS 39367-8161
(601) 381-2278
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00365
MS
Other
Enumeration date
01/31/2018
Last updated
12/23/2019
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