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Individual

DR. DEBORAH POTEET-JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
105 LEE PARKWAY DR, SUITE A, CHATTANOOGA, TN 37421-6708
(423) 855-9991
(423) 855-4262
Mailing address
105 LEE PARKWAY DR, SUITE A, CHATTANOOGA, TN 37421-6708
(423) 855-9991
(423) 855-4262

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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