Edwin Kent Davis Porter, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001086 Issued in GA

Practice address

404 Academy Ave
Dublin, GA 31021-5222

Phone

(478) 272-3445

Fax

(912) 489-6392

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1740229897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1009",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304591009",
            "telephone_number": "912-764-9147",
            "fax_number": "912-489-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 ACADEMY AVE",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310215222",
            "telephone_number": "478-272-3445",
            "fax_number": "912-489-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "EDWIN",
        "middle_name": "KENT DAVIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000355319A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Beck Pollock
• James Woodard Poole Jr., RPH
• Elizabeth Pooler, PHD
• Alan David Porter, LMSW
• Allison Porter, PHARMD
• Lanira Postell
• Carla Denise Potts, LCSW
• Celia Potts, PHARMD
• Anna Haralson Powell, NP-C
• Joyce Yvonne Powell, RN

• Optometrist in Dublin, GA
• Providers in Dublin, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.