Individual
MICHAEL L. POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
70 BOWER DR STE 240, MEDFORD, OR 97501-3689
(541) 732-8790
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD23161
OR
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD23161
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228818
—
OR
Enumeration date
06/27/2006
Last updated
11/29/2023
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