Provider Demographics
NPI:1942000302
Name:PORTER, JAMES THOMAS JR
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:PORTER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 EASTDALE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2909
Mailing Address - Country:US
Mailing Address - Phone:937-677-5507
Mailing Address - Fax:
Practice Address - Street 1:115 EASTDALE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2909
Practice Address - Country:US
Practice Address - Phone:937-677-5507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care