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General NPI Number Information
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NPI Number | 1942260864
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Entity Type | Individual
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Provider Name | RICHARD A POTTS DO
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 01/02/2021
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Provider Practice Location Address
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Address Line | 202 NORTH WEST ST
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City | ODON
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State | IN
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Zip | 47562
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Country | US
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Telephone | 812-636-7300
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Fax | 812-636-8204
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Provider Business Mailing Address
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Address Line | PO BOX 760 1314 EAST WALNUT ST
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City | WASHINGTON
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State | IN
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Zip | 47501
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Country | US
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Telephone | 812-254-7310
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Fax | 812-254-8602
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02000896A
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License Number State | IN
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