Individual
ERIC C POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2033 MEADOWVIEW LN, STE 200, KINGSPORT, TN 37660-7569
(423) 857-2793
(423) 578-8025
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36165
TN
208000000X
Pediatrics Physician
36165
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38763541
—
TN
05
—
4142480
—
TN
01
—
4178280
BCBST
TN
01
—
7100046250
KENTUCKY MEDICAID
KY
01
—
P00635228
RAILROAD MEDICARE
—
Enumeration date
08/03/2005
Last updated
03/25/2013
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