Individual
JON WARREN POTTER
Active
Individual
JON WARREN POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
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
Update your record
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