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Individual

DAVID VAUGHN PORTER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
7450 KESSLER ST STE 202, MERRIAM, KS 66204-2553
(913) 632-9480
(913) 632-9499
Mailing address
7450 KESSLER ST STE 202, MERRIAM, KS 66204-2553
(913) 632-9480
(913) 632-9499

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
15-03060
KS
363AM0700X
Medical Physician Assistant
2017036354
MO

Other

Enumeration date
10/10/2017
Last updated
07/02/2025
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