Individual
DOUGLAS ALAN POTTS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-1234
Mailing address
295 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1287
(801) 587-7450
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35138895
OH
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
13293976-1205
UT
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
35138895
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0457149
—
OH
Enumeration date
04/03/2017
Last updated
03/06/2024
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