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DR. RAYMOND L. PORTIS M.D.

Physicians Internal Medicine Critical Care Medicine

Provider NPI: 1437312915

Provider Information:
DR. RAYMOND L. PORTIS M.D.
Gender: M
Not Sole Proprietor

Practice Location:
1200 N STATE ST SUITE 480 JACKSON, MS 39202-2000 US
Tel: 601-352-2273  Fax: 601-714-3415

Business Mailing Address:
971 LAKELAND DR STE 1052 JACKSON, MS 39216-4609 US
Tel: 601-206-6100  Fax: 601-206-6052

NPI Information:
NPI: 1437312915
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207RC0200XPhysicians
Internal Medicine
Critical Care Medicine
MS21256
Y207RP1001XPhysicians
Internal Medicine
MS21256

Other Provider Identifiers:

IssuerNumberStateType
00809533MS05



American Medical Association 2012 taxonomy code information

Code: 207RP1001X

Type:

Classification:



Definition:



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