Individual
DR. TODD R PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4096
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4096
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036158039
IL
208000000X
Pediatrics Physician
40048
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53170580
—
CO
Enumeration date
10/25/2006
Last updated
08/24/2021
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