Individual
KIM POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1980 NONCONNAH BLVD, MEMPHIS, TN 38132-2123
(901) 291-3900
Mailing address
6210 MALLOCH DR, MEMPHIS, TN 38119-6327
(901) 736-2387
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
46257
TN
207Q00000X
Family Medicine Physician
Primary
MD0000046257
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518265
—
TN
Enumeration date
08/07/2008
Last updated
09/29/2023
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