Individual
DR. KEITH G PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-4000
(423) 224-3258
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35985
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3870838
—
TN
Enumeration date
06/02/2006
Last updated
03/27/2008
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