Individual
JOHN M PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, UMMC DEPARTMENT OF SURGERY, JACKSON, MS 39216-4500
(601) 815-1312
(601) 815-4570
Mailing address
2500 N STATE ST, UMMC DEPARTMENT OF SURGERY, JACKSON, MS 39216-4500
(601) 815-1312
(601) 815-4570
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
19827
MS
2086S0127X
Trauma Surgery Physician
19827
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00736216
—
MS
05
—
642422
—
AZ
01
—
P00797090
RAILROAD MEDICARE
MS
01
—
P01185849
RAILROAD MEDICARE
MS
Enumeration date
10/18/2006
Last updated
10/23/2013
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