Organization
J T POTTER JR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES THOMAS POTTER MD (CEO)
(276) 679-0800
Entity
Organization
Contact information
Practice address
611 TRENT ST NE, SUITE A, NORTON, VA 24273
(276) 679-0800
Mailing address
159 RIDGEFIELD RD SW, WISE, VA 24293-5607
(276) 679-0800
(276) 679-0097
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
0101232468
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010002761
—
VA
Enumeration date
07/15/2006
Last updated
12/23/2019
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