Organization
MS PMR & PMC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE EDWARD PORTER MD (MANAGING MEMBER)
(662) 841-8830
Entity
Organization
Contact information
Practice address
144 S THOMAS ST, BUILDING 1, SUITE 101-2, TUPELO, MS 38801-5312
(662) 841-8830
(662) 841-8832
Mailing address
144 S THOMAS ST, BUILDING 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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05458278
—
MS
Enumeration date
05/30/2007
Last updated
07/21/2008
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