Individual
CAROL JEAN POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-6200
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
35061792
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107287000
—
WV
01
—
0704383
CGS - MEDICARE
OH
05
—
0843270
—
OH
05
—
64868300
—
KY
Enumeration date
09/27/2005
Last updated
11/19/2024
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