Individual
DR. MARYA JANCINTA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15813 PAUL VEGA MD DR STE 200, HAMMOND, LA 70403-1431
(985) 230-7650
(985) 230-7655
Mailing address
PO BOX 2668, HAMMOND, LA 70404-2668
(985) 230-7650
(985) 230-7655
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
14501R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1123668
—
LA
Enumeration date
09/02/2006
Last updated
12/30/2022
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