Porter, Kirk

Porter, Kirk is an individual health care provider with primary practice located at 1107 E Matthews Ave Suite 200, Jonesboro AR 72401-4315. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Porter, Kirk can be contacted via phone (870) 931-4442.

Contact Information

Primary practice address
1107 E Matthews Ave Suite 200 Jonesboro AR 72401-4315
Phone: (870) 931-4442
Fax: (870) 802-0205
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PT2016-011 Arkansas

Profile Details

NPI number 1366801870
LBN Legal business name Porter, Kirk
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 12th, 2016
Last updated Nov 9th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366801870 NPPES
Arkansas MEDICAID 212903795

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