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Individual

DR. SALLY B PORTERA MANKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
211 S 3RD ST, BELLEVILLE, IL 62220-1915
(618) 234-2120
(618) 641-5410
Mailing address
1 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1099
(618) 234-2120
(618) 641-5410

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2009023911
MO
207L00000X
Anesthesiology Physician
Primary
36117761
IL

Other

Enumeration date
05/03/2007
Last updated
12/31/2020
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