Individual
STEVEN JARED POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
480 RIGBY LAKE DRIVE, RIGBY, ID 83442
(208) 745-3500
(208) 745-3501
Mailing address
480 RIGBY LAKE DRIVE, RIGBY, ID 83442
(801) 230-5182
(208) 745-3501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
57481181205
UT
207Q00000X
Family Medicine Physician
Primary
M-19057
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57481181205
LICENSE NUMBER
UT
Enumeration date
11/28/2006
Last updated
04/24/2020
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