Potts, Jack
Potts, Jack is an sole proprietor health care provider with primary practice located at 221 E Indianola Ave , Phoenix AZ 85012-2002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Forensic Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Forensic Psychiatry is his primary health care specialty. Potts, Jack can be contacted via phone (602) 274-5494.Contact Information
Primary practice address
221 E Indianola Ave
Phoenix AZ 85012-2002
Phone: (602) 274-5494
Fax: (602) 264-5566
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Forensic Psychiatry | 2084F0202X | AZ12185 | Arizona |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 12185 | Arizona |
Profile Details
| NPI number | 1245348812 |
|---|---|
| LBN Legal business name | Potts, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 25th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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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