Organization
PORTIS MEDICAL SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND L PORTIS II MD (PRESIDENT)
(601) 936-6001
Entity
Organization
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 936-6001
(601) 936-4389
Mailing address
PO BOX 24023, JACKSON, MS 39225-4023
(601) 936-6001
(601) 936-4389
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
21256
MS
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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