Potter, James G

Potter, James G is an individual health care provider with primary practice located at 3500 Tower Avenue , Superior WI 54880-5335. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Potter, James G can be contacted via phone (715) 817-7100.

Contact Information

Primary practice address
3500 Tower Avenue Superior WI 54880-5335
Phone: (715) 817-7100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3621-23 Wisconsin

Profile Details

NPI number 1669470845
LBN Legal business name Potter, James G
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Aug 9th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669470845 NPPES
Wisconsin MEDICAID 42908100
Wisconsin Other 1018475

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