Porter, John Charles
Porter, John Charles is an sole proprietor health care provider with primary practice located at 6527 W Bloomfield Rd , Glendale AZ 85304-1652. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Porter, John Charles can be contacted via phone (623) 764-2894.Contact Information
Primary practice address
6527 W Bloomfield Rd
Glendale AZ 85304-1652
Phone: (623) 764-2894
Fax: (623) 878-8712
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | 15286 | Arizona |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 15286 | Arizona |
Profile Details
| NPI number | 1700940541 |
|---|---|
| LBN Legal business name | Porter, John Charles |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Apr 11th, 2014 - about 11 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 | 1700940541 | NPPES |
| Arizona | MEDICAID | 247173 |
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