Individual
JEFFERY DAVID PORTH
Active
Individual
JEFFERY DAVID PORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
359456-1205
UT
207L00000X
Anesthesiology Physician
Primary
MD.019129
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050061428
RAILROAD MEDICARE
UT
05
—
D2559
—
UT
Enumeration date
10/25/2006
Last updated
04/25/2023
Update your record
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