Organization
POTTS PEDIATRICS AND ADOLESCENT MEDICINE AND PREVENATATIVE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH STAATS (OFFICE ADMINISTRATOR)
(770) 461-5003
Entity
Organization
Contact information
Practice address
365 N JEFF DAVIS DR, FAYETTEVILLE, GA 30214-1627
(770) 461-5003
Mailing address
365 N JEFF DAVIS DR, FAYETTEVILLE, GA 30214-1627
(770) 461-5003
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
17642
GA
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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