Andrew W Porter MD

Organization Active NPI Family Medicine Physician · Gilbertsville, KY

NPI 1740439652 · NPPES record last updated Feb 18, 2009

Key facts

NPI
1740439652
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
20835 (KY)
Legal business name
ANDREW W PORTER MD
Practice address
112 Point Cir
Gilbertsville, KY 42044-9224
Phone
(270) 703-3309
NPI assigned
Sep 16, 2008
Organization subpart
No

Authorized official

Name
Teresa Johnson
Title
Billing Agency
Phone
(270) 382-3112

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 20835 KY Yes

Addresses

Primary practice location

112 Point Cir
Gilbertsville, KY 42044-9224

Mailing address

PO Box 15
Lynnville, KY 42063-0015
Phone (270) 382-3112

Other identifiers

IdentifierTypeStateIssuer
64208358MedicaidKY

Other providers in Gilbertsville, KY

All providers in Gilbertsville, KY · Family Medicine Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.