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1043718398
DAVID ANDREW PORTER
JACKSON, MS
NPI
1043718398
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MS 00365)
Enumeration Date
2018-01-31
Last Update Date
2019-12-23
Business Address
DAVID ANDREW PORTER PA
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-1000
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Mailing Address
DAVID ANDREW PORTER PA
577 OLD HIGHWAY 84 RD
WAYNESBORO, MS 39367-8161
Phone number: 601-381-2278
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