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Individual

WILLIAM C PORTER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5000
Mailing address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 885-5000

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
11121
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00016876
MS
05
1361461
LA
01
4522324
AETNA
MS
Enumeration date
07/06/2006
Last updated
09/10/2020
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