Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD0000009332 | TN |
NPI | 1124078647 |
---|---|
Provider Name | James Porterfield |
First Address | Memphis, TN 38150-0001 |
Second Address | Memphis, TN 38104-6638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 24/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00119548 | (05) | MS |
3185780 | (05) | TN |
B04208 | (02) | TN |