Individual
DR. JEFFERY SCOTT PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
401 CARPENTER RD BLDG 525, ROOM 120, FORT MYER, VA 22211-1009
(703) 696-3614
Mailing address
401 CARPENTER RD BLDG 525, ROOM 1015, FT MYER, VA 22211-1009
(703) 696-3614
(703) 696-9248
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0102201237
VA
Other
Enumeration date
12/19/2005
Last updated
12/05/2014
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