Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lewis Gordon Porter IV, PA-C

Individual provider Physician Assistant · NPI 1255491585

Lewis Gordon Porter IV, PA-C is a Physician Assistant in Johnson City, Tennessee. Licensed in Tennessee. Registered with an NPI since 2006.

Licensed in
TN
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3 Professional Park Dr Ste 21
Johnson City, TN 37604-6529
Phone: (423) 434-6300
Fax: (423) 434-6312
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1461 (TN)

Record details

NPI number1255491585
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 8, 2006
Last updated in NPPESMarch 27, 2008

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