Organization
ANDREW W PORTER MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA JOHNSON (BILLING AGENCY)
(270) 382-3112
Entity
Organization
Contact information
Practice address
112 POINT CIR, GILBERTSVILLE, KY 42044-9224
(270) 703-3309
Mailing address
PO BOX 15, LYNNVILLE, KY 42063-0015
(270) 382-3112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20835
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64208358
—
KY
Enumeration date
09/16/2008
Last updated
02/18/2009
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