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General NPI Number Information
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NPI Number | 1548678311
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Entity Type | Individual
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Provider Name | MICHAEL GENE POTTER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 1920 HIGHWAY 73
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City | ATCHISON
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State | KS
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Zip | 66002-5102
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Country | US
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Telephone | 913-367-6142
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Fax | 913-367-9698
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Provider Business Mailing Address
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Address Line | 27082 179TH ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-7191
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Country | US
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Telephone | 816-835-7103
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2011023433
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-14941
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License Number State | KS
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