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Individual

DR. JON KEVIN PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
425 PEARL ST, BURLINGTON, VT 05401-3308
(802) 656-3350
(802) 656-8178
Mailing address
425 PEARL ST, BURLINGTON, VT 05401-3308
(802) 656-3350
(802) 656-8178

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0420008579
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003903
VT
Enumeration date
06/09/2006
Last updated
03/01/2010
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