Individual
JAMES AUSTIN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1802 BRAEBURN DR, SUITE M120, SALEM, VA 24153-7357
(540) 344-3668
(540) 774-4615
Mailing address
1802 BRAEBURN DR, SUITE M120, SALEM, VA 24153-7357
(540) 344-3668
(540) 774-4615
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110840594
VA
363AS0400X
Surgical Physician Assistant
0110840594
VA
Other
Enumeration date
01/30/2006
Last updated
02/13/2008
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