Individual
DR. JILL Y PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
265 W UNION ST STE A, ATHENS, OH 45701-2313
(740) 594-2456
(740) 594-9630
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
(740) 594-2456
(740) 594-9630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-007469
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000272687
ANTHEM
OH
05
—
2342174
—
OH
01
—
4090107
MEDICARE
OH
Enumeration date
03/17/2006
Last updated
05/02/2024
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