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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LANCE WESLEY PORT, PA-C

Active

LANCE WESLEY PORT, PA-C is a Medical Physician Assistant healthcare provider located in SALMON, Idaho. NPI 1578222188 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · SALMON, ID

Registration Details

NPI Number
1578222188
Provider Type
Individual
Gender
Male
NPI Issued
Dec 10, 2021 (4.7228548305335 yrs)
Last Updated
Dec 10, 2021

Practice Information

Address
103 S DAISY ST
SALMON, ID, 83467
Browse ID providers · Browse ZIP 83467
Phone
2087566212
Primary Specialty
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.