Individual
DR. MARK PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3530 E SPAULDING AVE, PUEBLO, CO 81008-2209
(719) 296-0077
(719) 595-7408
Mailing address
1338 PHAY AVE, CANON CITY, CO 81212-2311
(719) 285-2647
(719) 595-7408
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
45239
CO
207X00000X
Orthopaedic Surgery Physician
AFE69459
CA
207XX0801X
Orthopaedic Trauma Physician
DR.0045239
CO
Other
Enumeration date
10/16/2006
Last updated
02/03/2021
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