Porter, Burdett Roy
Porter, Burdett Roy is an individual health care provider with primary practice located at 1 Guthrie Sq , Sayre PA 18840-1625. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Clinical Informatics, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Porter, Burdett Roy can be contacted via phone (570) 887-6133.Contact Information
Primary practice address
1 Guthrie Sq
Sayre PA 18840-1625
Phone: (570) 887-6133
Fax: (570) 887-4464
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 217587-1 | New York |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 217587-1 | New York |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | MD042659L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Clinical Informatics | 2083C0008X | MD042659L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 217587-1 | New York |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | MD042659L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | MD042659L | Pennsylvania |
Profile Details
| NPI number | 1194798819 |
|---|---|
| LBN Legal business name | Porter, Burdett Roy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Mar 1st, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194798819 | NPPES |
| Pennsylvania | MEDICAID | 0017472240001 | |
| Pennsylvania | MEDICAID | 01950201 | |
| Pennsylvania | Other | CC9269 | |
| Pennsylvania | Other | GU039832 | |
| Pennsylvania | Other | 050075753 |
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