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Dustin Porter — NPI 1205178399, Burley, ID | NPI Central

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NPI 1205178399

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Dustin Porter

NPI 1205178399 · Surgery Physician · Burley, ID

Provider details

NPI number: 1205178399
Entity type: Individual
Primary specialty: Surgery PhysicianAllopathic & Osteopathic Physicians
Sex: Male
Sole proprietor: No

Specialties & taxonomies

Surgery PhysicianPrimary208600000XLicense M-14207 (ID)
Allopathic & Osteopathic Physicians
Student in an Organized Health Care Education/Training Program390200000X
Student, Health Care

Practice location

1501 Hiland Ave Ste H

Burley, ID 83318-2688

Phone: (208) 677-6082

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

Po Box 30180

Salt Lake City, UT 84130-0180

Additional practice locations (1)

550 S Jackson St
Room A2j21
Louisville, KY 40202-1622
Phone: (502) 852-6191

Registry dates

Enumerated: 2013-03-26
Last updated: 2026-03-03
Certified: 2026-03-03

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.