Individual
CARL DOUGLAS PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MEDICAL CENTER DR, SPRINGFIELD, OH 45504-2687
(937) 523-1034
(937) 523-1966
Mailing address
100 MEDICAL CENTER DR, SPRINGFIELD, OH 45504-2687
(937) 523-1034
(937) 523-1966
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35064697
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0922443
—
OH
Enumeration date
07/15/2005
Last updated
04/12/2016
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