Individual
DR. JAKE J PORTER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MPH
Contact information
Practice address
1240 EAGLES LANDING PKWY STE 300, STOCKBRIDGE, GA 30281-5173
(770) 506-4350
(770) 506-9860
Mailing address
900 CIRCLE 75 PKWY SE STE 1700, ATLANTA, GA 30339-3087
(770) 953-6929
(770) 953-6972
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
72625
GA
207X00000X
Orthopaedic Surgery Physician
MD460968
PA
Other
Enumeration date
06/19/2012
Last updated
02/08/2021
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