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Organization

PAUL R PORTER MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL RANDALL PORTER MD (OWNER)
(615) 325-6446
Entity
Organization

Contact information

Practice address
934 S BROADWAY ST, STE 3, PORTLAND, TN 37148-1700
(615) 325-6446
(615) 325-2165
Mailing address
934 S BROADWAY ST, STE 3, PORTLAND, TN 37148-1700
(615) 325-6446
(615) 325-2165

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary

Other

Enumeration date
06/26/2014
Last updated
06/26/2014
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