Individual
ROGER D PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7579 ALEXANDRIA PIKE, ALEXANDRIA, KY 41001-1041
(859) 635-6666
(859) 635-6607
Mailing address
6200 PLEASANT AVE, STE 3, FAIRFIELD, OH 45014-4671
(513) 829-9333
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
239
KY
213ES0131X
Foot Surgery Podiatrist
KY239
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80002397
—
KY
01
—
P00141188
RAILROAD MEDICARE
KY
Enumeration date
05/24/2005
Last updated
03/22/2016
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