Individual
DR. LEWIS E PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5 MEDICAL PARK DR, SUITE GL2, BENTON, AR 72015-3729
(501) 778-4862
(501) 778-4685
Mailing address
PO BOX 1615, SEARCY, AR 72145-1615
(501) 776-6093
(501) 776-6019
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E5015
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407883044
BCBS
AR
05
—
164093001
—
AR
Enumeration date
06/27/2006
Last updated
06/23/2014
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