Individual
DR. DARRELL JACK POTTER
Active
Individual
DR. DARRELL JACK POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2006-01651
NC
207X00000X
Orthopaedic Surgery Physician
2016005465
MO
207X00000X
Orthopaedic Surgery Physician
Primary
4301030727
MI
207X00000X
Orthopaedic Surgery Physician
MD-42830
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41005
—
AL
01
—
51041005
BCBS
AL
Enumeration date
01/20/2006
Last updated
11/03/2019
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