Potter, Kevin Wayne

Potter, Kevin Wayne is an individual health care provider with primary practice located at 7330 N 99Th Ave Ste 200 , Glendale AZ 85307-3018. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Potter, Kevin Wayne can be contacted via phone (602) 406-4786.

Contact Information

Primary practice address
7330 N 99Th Ave Ste 200 Glendale AZ 85307-3018
Phone: (602) 406-4786
Fax: (916) 636-4358
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 005313 Arizona

Profile Details

NPI number 1831355643
LBN Legal business name Potter, Kevin Wayne
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2008
Last updated May 18th, 2021 - about 5 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 1831355643 NPPES
Arizona Other Z199540 MEDICARE
Arizona MEDICAID 445137 MEDICARE

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