Individual
DR. KENNETH C POTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1153 CENTRE ST, JAMAICA PLAIN, MA 02130-3446
(617) 983-7926
(617) 983-7455
Mailing address
7 CABOT RD, WAYLAND, MA 01778-3707
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
54708
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700342
TUFTS HEALTH PLAN ID
MA
01
—
JO5685
BCBS OF MA
MA
Enumeration date
11/17/2006
Last updated
07/08/2007
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