Porter, Randall W
Porter, Randall W is an individual health care provider with primary practice located at 2910 N 3Rd Ave , Phoenix AZ 85013-4434. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Porter, Randall W can be contacted via phone (602) 406-4856.Contact Information
Primary practice address
2910 N 3Rd Ave
Phoenix AZ 85013-4434
Phone: (602) 406-4856
Fax: (602) 406-3369
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 28395 | Arizona |
Profile Details
| NPI number | 1730176389 |
|---|---|
| LBN Legal business name | Porter, Randall W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2005 |
| Last updated | Jan 6th, 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 | 1730176389 | NPPES |
| Arizona | MEDICAID | 509888 |
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