Provider Demographics
NPI:1124078647
Name:PORTERFIELD, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:PORTERFIELD
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 357
Mailing Address - Street 2:DEPT 130
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38150-0001
Mailing Address - Country:US
Mailing Address - Phone:901-274-2643
Mailing Address - Fax:901-726-4237
Practice Address - Street 1:1211 UNION AVE
Practice Address - Street 2:SUITE 475
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6638
Practice Address - Country:US
Practice Address - Phone:901-274-2643
Practice Address - Fax:901-726-4237
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000009332207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00119548Medicaid
TN3185780Medicaid
AR5L133Medicare ID - Type Unspecified
TN3185780Medicare ID - Type Unspecified
TNB04208Medicare UPIN