Provider Demographics
NPI:1104074236
Name:PORR, WILLIAM HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
Last Name:PORR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7987
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36670-0987
Mailing Address - Country:US
Mailing Address - Phone:251-633-0573
Mailing Address - Fax:251-633-7367
Practice Address - Street 1:5955 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3135
Practice Address - Country:US
Practice Address - Phone:251-633-0573
Practice Address - Fax:251-633-7367
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37294207RC0200X, 207RP1001X, 207RC0200X, 207RP1001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL218636Medicaid
AL512-15873OtherBCBS OF AL
AL630799312OtherHUMANA CHOICE
AL0810349OtherCIGNA
AL5979732OtherUNITED HEALTHCARE
MS09507364Medicaid
AL218634Medicaid
AL512-15881OtherBCBS OF AL
AL221255Medicaid
ALA03141I901OtherMEDICARE
AL221249Medicaid
AL512-15871OtherBCBS OF AL
ALZ54925OtherVIVA HEALTH
AL240048Medicaid
AL512-15878OtherBCBS OF AL
MS630799312OtherMAGNOLIA HEALTH
AL219488Medicaid
AL4555452OtherAETNA
AL512-15876OtherBCBS OF AL