Individual
JON WARREN POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4109 OAKWOOD HILLS PARKWAY, EAU CLAIRE, WI 54701-8888
(715) 552-7303
(715) 552-7355
Mailing address
4109 OAKWOOD HILLS PARKWAY, EAU CLAIRE, WI 54701-8888
(715) 552-7303
(715) 552-7355
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
036-132113
IL
207RG0100X
Gastroenterology Physician
04791
IA
207RG0100X
Gastroenterology Physician
Primary
44787-021
WI
207RG0100X
Gastroenterology Physician
JP016277
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1055201131
BLUE CROSS BLUE SHIELD
MI
05
—
43546500
—
WI
05
—
4693501
—
MI
01
—
P00165661
RAILROAD MEDICARE
MI
Enumeration date
01/23/2006
Last updated
05/24/2024
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