Porter, Alphonso D
Porter, Alphonso D is an sole proprietor health care provider with primary practice located at 3118-A Washington Rd , East Point GA 30346. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Porter, Alphonso D can be contacted via phone (404) 767-3995.Contact Information
Primary practice address
3118-A Washington Rd
East Point GA 30346
Phone: (404) 767-3995
Fax: (404) 767-3987
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 488 | Georgia |
Profile Details
| NPI number | 1215109996 |
|---|---|
| LBN Legal business name | Porter, Alphonso D |
| Credentials | LDO |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 2nd, 2008 |
| Last updated | Apr 2nd, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215109996 | NPPES |
| Georgia | MEDICAID | 00248289C |
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