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Individual

DEAN M PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
251 SKAGGS ROAD, BRANSON, MO 65616
(417) 335-7218
(417) 334-1507
Mailing address
PO BOX 650, BRANSON, MO 65615
(417) 335-7218
(417) 334-1507

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2005030567
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
126814
BCBS
01
250766
HEALTHLINK
01
P00398195
RAILROAD MEDICARE
Enumeration date
07/10/2006
Last updated
01/19/2008
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