Individual
SCOTT T. POTTRATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1499 FAIR RD, STATESBORO, GA 30458-1683
(912) 486-1510
Mailing address
5629 HWY 21 S, RINCON, GA 31326-9416
(912) 295-2133
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01036697
IN
207P00000X
Emergency Medicine Physician
Primary
072760
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000365696
BSIN
IN
05
—
100119850
—
IN
Enumeration date
05/25/2006
Last updated
02/16/2018
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