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Individual
DR. KIRK DAVID POTTER
Active
Individual
DR. KIRK DAVID POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
05-33528
KS
208600000X
Surgery Physician
05-33528
KS
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
05-33528
KS
208D00000X
General Practice Physician
05-33528
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1613811
HIGHMARK BLUE SHIELD
PA
05
—
200582300I
—
KS
01
—
2290955000
KEYSTONE IBC
PA
01
—
34935
HEALTH PARTNERS
PA
01
—
P00189173
RAILROAD MEDICARE
PA
Enumeration date
08/18/2006
Last updated
11/28/2023
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