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General NPI Number Information
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NPI Number | 1023406931
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Entity Type | Organization
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Legal Business Name | JOSEPH A POTOCKI DO INC
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 531 ROBBINS AVE
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City | NILES
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State | OH
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Zip | 44446-2411
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Country | US
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Telephone | 330-544-3431
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Fax | 330-544-3432
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Provider Business Mailing Address
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Address Line | 531 ROBBINS AVE
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City | NILES
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State | OH
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Zip | 44446-2411
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Country | US
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Telephone | 330-544-3431
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Fax | 330-544-3432
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH A POTOCKI
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Credential | D.O.
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Telephone | 330-544-3431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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