Potter, Jeffrey N

Potter, Jeffrey N is an individual health care provider with primary practice located at 805 Hall St , Wiggins MS 39577-2110. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Potter, Jeffrey N can be contacted via phone (601) 928-4412.

Contact Information

Primary practice address
805 Hall St Wiggins MS 39577-2110
Phone: (601) 928-4412
Fax: (601) 579-5240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 23577 Mississippi
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD024152E Pennsylvania

Profile Details

NPI number 1700861465
LBN Legal business name Potter, Jeffrey N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated Jul 9th, 2020 - about 6 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 1700861465 NPPES
Other 50000729 CAP BLUE CROSS
MEDICAID 05706756 CAP BLUE CROSS
MEDICAID 0008570430005 CAP BLUE CROSS
Other 151890 CAP BLUE CROSS

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