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1588079305
SAMUEL GRANT PORTER
OLATHE, KS
NPI
1588079305
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: KS 04-38118)
Enumeration Date
2014-07-01
Last Update Date
2019-01-29
Business Address
SAMUEL GRANT PORTER MD
800 W FRONTIER LN
OLATHE, KS 66061
Phone number: 913-397-7800
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Mailing Address
SAMUEL GRANT PORTER MD
961 E SHALIMAR DR
COLUMBIA, MO 65202-1093
Phone number: 309-202-7445
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