Provider Demographics
NPI:1194721621
Name:PORTER, JAMES W (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:PORTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 N BROADWAY BLDG A
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3959
Mailing Address - Country:US
Mailing Address - Phone:303-455-6345
Mailing Address - Fax:303-455-6343
Practice Address - Street 1:1 N BROADWAY BLDG A
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3959
Practice Address - Country:US
Practice Address - Phone:303-455-6345
Practice Address - Fax:303-455-6343
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2016-09-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME42222207P00000X
CODR.0056278207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0680702-00Medicaid
E32341Medicare UPIN
FL96225WMedicare ID - Type UnspecifiedDELRAY MEDICAL CENTER