Potts, Richard Glen
Potts, Richard Glen is an individual health care provider with primary practice located at 835 S Van Buren St , Green Bay WI 54301-3526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Potts, Richard Glen can be contacted via phone (920) 496-4700.Contact Information
Primary practice address
835 S Van Buren St
Green Bay WI 54301-3526
Phone: (920) 496-4700
Fax: (920) 272-1239
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 32223 | Wisconsin |
Profile Details
| NPI number | 1124044813 |
|---|---|
| LBN Legal business name | Potts, Richard Glen |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2006 |
| Last updated | Jul 30th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124044813 | NPPES |
| Wisconsin | MEDICAID | 30053700 |
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