Individual
DONALD W PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
628 N 14TH ST, MURPHYSBORO, IL 62966-1807
(618) 687-2353
(618) 687-9511
Mailing address
647 N 2ND ST, MURPHYSBORO, IL 62966-3335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036049761
IL
Other
Enumeration date
11/07/2006
Last updated
02/29/2012
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