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Organization

FRED E. POTTS, IV, MD, LLC

Active
Parent organization
FRED E. POTTS, IV, MD, LLC
Other names
Covenant Primary Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
FRED E. POTTS, IV, MD, LLC
Authorized official
DR. FRED E. POTTS IV MD (MEDICAL DIRECTOR)
(816) 233-3700
Entity
Organization

Contact information

Practice address
4906 FREDERICK AVE, SAINT JOSEPH, MO 64506-3246
(816) 233-3700
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary

Other

Enumeration date
10/09/2012
Last updated
10/09/2012
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