Individual
DR. DEBORAH POTEET-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD16576
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000790655A
—
GA
05
—
198054324A
—
GA
01
—
270029166
TAX ID
TN
05
—
3825543
—
TN
01
—
4051818
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
09/02/2006
Last updated
01/14/2008
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