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Individual

DR. RICCI R. PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
850 W HOSPITAL DR, STE D, FULTON, MO 65251
(573) 642-5338
(573) 642-9224
Mailing address
850 N HOSPITAL DR, STE F, FULTON, MO 65251-2535
(575) 642-5338
(573) 642-9224

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34445
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
240826537
MO
Enumeration date
12/19/2005
Last updated
08/09/2013
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