Individual
DR. NEILL C PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4612 29TH AVE, MERIDIAN, MS 39305-1652
(601) 485-8535
Mailing address
4612 29TH AVE, MERIDIAN, MS 39305-1652
(601) 485-8535
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
16337
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120925
—
MS
Enumeration date
01/31/2007
Last updated
07/08/2007
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