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Mr. Ryan Todd Porter, PA-C
Surgical Physician Assistant in Blackfoot, Idaho
NPI 1669556213

Ryan Todd Porter is a Surgical Physician Assistant based in Blackfoot, ID and is specialized in Surgical. Ryan Todd Porter practices in Blackfoot, ID and has the professional credentials of PA-C. The NPI Number for Ryan Todd Porter is 1669556213 and holds a License No. 447 (Idaho).

The current practice location address for Ryan Todd Porter is 98 Poplar St, Blackfoot, ID and can be reached out via phone at 208-785-4100.

Location: 98 Poplar St, Blackfoot, ID, 83221-1758
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Provider Profile Details
NPI Number
1669556213
Provider Name
Ryan Todd Porter
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
98 Poplar St, Blackfoot, ID, 83221-1758
Phone Number
208-785-4100
Fax Number
Provider Enumeration Date
10/24/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4307719 05 MT
808517600 05 ID
institution
Provider Business Practice Location Address Details
Address
98 Poplar St
City
State
Zip
83221-1758
Phone Number
208-785-4100
Fax Number
person
Provider Business Mailing Address Details
Address
98 Poplar St
City
State
Zip
83221-1758
Phone Number
208-785-4100
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
447 (Montana)
Definition
Definition to come...
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