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NPI Code Detail

MEDICARE: JOSHUA WAYNE POTTER RN

MEDICARE: JOSHUA WAYNE POTTER RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician0024174949VA

General Provider Information

NPI Number : 1952832461
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA WAYNE POTTER RN
Provider Business Mailing Address
First Line : 3708 LITTON PL
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-4768
Country : US
Telephone Number : 859-797-7159
Fax Number :
Provider Business Practice Location Address
First Line : 7101 JAHNKE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23225-4044
Country : US
Telephone Number : 804-483-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2017
Last Update Date : 03/13/2023

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