Individual
JOHN-ROBERT LA PORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10315 DAWSONS CREEK BLVD STE AB, FORT WAYNE, IN 46825-1912
(260) 436-7875
(260) 432-9812
Mailing address
PO BOX 843603, DALLAS, TX 75284-3603
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01087269A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811213721
—
IN
Enumeration date
04/16/2010
Last updated
06/24/2024
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