Provider Demographics
NPI:1437174265
Name:PORCARO, JOSEPH P (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:PORCARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N MADISON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-3453
Mailing Address - Country:US
Mailing Address - Phone:765-298-5181
Mailing Address - Fax:765-298-5821
Practice Address - Street 1:1515 N MADISON AVENUE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3453
Practice Address - Country:US
Practice Address - Phone:765-298-5181
Practice Address - Fax:765-298-5821
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010309192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E45968Medicare UPIN
IN505730AMedicare ID - Type Unspecified