Individual
JOHN G PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
790 CHURCH ST NE, SUITE 550, MARIETTA, GA 30060-7282
(770) 419-9902
(770) 419-7457
Mailing address
790 CHURCH ST NE, SUITE 550, MARIETTA, GA 30060-7282
(770) 419-9902
(770) 419-7457
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
026620
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
026620
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710946322
GROUP NPI NUMBER
GA
01
—
2147453
CIGNA
GA
Enumeration date
06/16/2006
Last updated
01/12/2011
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