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Individual

STACY PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7400 E OSBORN RD, SCOTTSDALE, AZ 85251-6432
(248) 898-5000
Mailing address
PO BOX 2808, SCOTTSDALE, AZ 85252-2808

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
43003
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
43003
ARIZONA MEDICAL LICENSE
AZ
Enumeration date
07/12/2007
Last updated
01/05/2015
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