Individual
DR. JUSTIN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
175 S 3RD ST, COLUMBUS, OH 43215-5134
(480) 868-7951
Mailing address
1 ILLINI DR, PEORIA, IL 61605-2576
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35.154180
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2023
Last updated
07/18/2025
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