Porter, Wendell Keith

Porter, Wendell Keith is an individual health care provider with primary practice located at 1105 Oak Cluster Dr , Sevierville TN 37862-6079. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Porter, Wendell Keith can be contacted via phone (865) 908-3636.

Contact Information

Primary practice address
1105 Oak Cluster Dr Sevierville TN 37862-6079
Fax: (865) 908-3644
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X NCCPA:1040254

Profile Details

NPI number 1487624623
LBN Legal business name Porter, Wendell Keith
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Jun 25th, 2014 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487624623 NPPES
South Carolina MEDICAID 0626PA

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