Organization
PHYSICIAN PRACTICE ORGANIZATION
Active
Other names
Sandcrest Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J PORTER MD (MEDICAL DIRECTOR)
(812) 373-2701
Entity
Organization
Contact information
Practice address
3203 MIDDLE DR, COLUMBUS, IN 47203-4427
(812) 373-2701
(812) 373-2710
Mailing address
3203 MIDDLE DR, COLUMBUS, IN 47203-4427
(812) 373-2701
(812) 373-2710
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207Q00000X
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100051320A
—
IN
Enumeration date
07/30/2006
Last updated
01/27/2014
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