Individual
THOMAS R POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5000
(601) 883-5196
Mailing address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5000
(601) 883-5196
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R865054
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00639559
—
MS
05
—
1358886
—
LA
01
—
P00675194
RAIL ROAD MEDICARE
—
Enumeration date
04/20/2007
Last updated
04/08/2009
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