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Individual

LEWIS L POTYONDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4280 N VALDOSTA RD, VALDOSTA, GA 31602-6814
(229) 671-2066
Mailing address
PO BOX 8846, GREENSBORO, NC 27419-0846
(336) 553-1659
(336) 553-3994

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
059856
GA
207L00000X
Anesthesiology Physician
34863
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
910127566B
GA
05
910127566C
GA
05
994518
AZ
Enumeration date
03/14/2006
Last updated
04/01/2010
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