Individual
JENNIFER M. PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
555 S FLOYD ST, LOUISVILLE, KY 40202-3822
(502) 588-3440
(502) 588-3441
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-3440
(502) 588-3441
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35.121719
OH
208000000X
Pediatrics Physician
Primary
48781
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201360100
—
IN
05
—
7100307420
—
KY
Enumeration date
04/13/2010
Last updated
10/27/2020
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