Individual
DR. BRUCE EDWARD PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
144 S THOMAS ST, BUILDING NUMBER 1 SUITE 101-2, TUPELO, MS 38801-5312
(662) 841-8830
(662) 841-8832
Mailing address
144 S THOMAS ST, BUILDING NUMBER 1 SUITE 101-2, TUPELO, MS 38801-5312
(662) 841-8830
(662) 841-8832
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
18599
MS
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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