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Individual

ANDREW S. T. PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O., FAAFP

Contact information

Practice address
707 N EMPORIA ST, WICHITA, KS 67214-3707
(316) 858-3460
(316) 858-3458
Mailing address
PO BOX 1897, WICHITA, KS 67201-1897
(316) 268-8131
(316) 291-4788

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
05-31673
KS
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
05-31673
KS

Other

Enumeration date
05/25/2006
Last updated
12/01/2020
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