Potter, Phillip L

Potter, Phillip L is an sole proprietor health care provider with primary practice located at 1700 Hospital South Dr Suite 504, Austell GA 30106-6810. He recently has only one registered license in Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine, which is considered as his primary health care specialty. Potter, Phillip L can be contacted via phone (770) 819-9211.

Contact Information

Primary practice address
1700 Hospital South Dr Suite 504 Austell GA 30106-6810
Phone: (770) 819-9211
Fax: (770) 819-9616
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X 034220 Georgia

Profile Details

NPI number 1376642777
LBN Legal business name Potter, Phillip L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 22nd, 2006
Last updated Jan 4th, 2012 - about 14 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 1376642777 NPPES
Georgia MEDICAID 00463163B

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