Organization
FRED E. POTTS, IV, MD, LLC
Active
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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