Individual
JEFFERY S POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
50 WEDDINGTON BRANCH RD STE B, PIKEVILLE, KY 41501-3296
(606) 637-6377
Mailing address
1709 KY ROUTE 321 STE 3, PRESTONSBURG, KY 41653-9097
(606) 349-7474
(606) 349-7737
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02805
KY
207Q00000X
Family Medicine Physician
Primary
02805
KY
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
02805
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000360776
ANTHEM
KY
01
—
3000160
BWC
WV
05
—
3004971000
—
WV
05
—
64061328
—
KY
01
—
P00274419
RR-MEDICARE
KY
Enumeration date
07/24/2006
Last updated
09/17/2024
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