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Organization
PORTER PHYSICIAN SERVICES LLC
Active
Organization
PORTER PHYSICIAN SERVICES LLC
Active
Other names
Porter Occupational Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
GARY D NEWSOME (PRESIDENT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
3220 LANCER ST, PORTAGE, IN 46368-4495
(219) 764-8439
(219) 764-8463
Mailing address
PO BOX 2028, PORTAGE, IN 46368-5528
(219) 763-6858
(219) 763-4858
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
IN
Other
Enumeration date
05/31/2007
Last updated
07/21/2022
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