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General NPI Number Information
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NPI Number | 1093501306
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Entity Type | Organization
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Legal Business Name | POTTER ORTHOPEDICS
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 7522 SW 45TH AVE SPC 200
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City | AMARILLO
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State | TX
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Zip | 79119-5036
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Country | US
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Telephone | 806-214-0007
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50239
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City | AMARILLO
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State | TX
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Zip | 79159-0239
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Country | US
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Telephone | 806-214-0007
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Fax | 806-214-0008
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Authorized Official
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Title or Position | OWNER, PHYSICIAN
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Name | DR. GORDEN DAVID POTTER III
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Credential | MD
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Telephone | 940-636-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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