Individual
RICHARD GLEN POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 496-4700
(920) 272-1239
Mailing address
PO BOX 19070, PREVEA HEALTH, GREEN BAY, WI 54307-9070
(920) 496-4700
(920) 272-1239
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
32223
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30053700
—
WI
Enumeration date
07/14/2006
Last updated
07/30/2008
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