Individual
DR. EDWIN KENT DAVIS PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
404 ACADEMY AVE, DUBLIN, GA 31021-5222
(478) 272-3445
(912) 489-6392
Mailing address
PO BOX 1009, STATESBORO, GA 30459-1009
(912) 764-9147
(912) 489-6392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001086
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000355319A
—
GA
Enumeration date
06/05/2006
Last updated
01/04/2013
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