Jack Benson Potter, MD Valid NPI

Individual provider · Allergy & Immunology (Internal Medicine) Physician · Atlanta, GA

NPI

1073666087

Type

Individual (Type 1)

Primary specialty

Allergy & Immunology (Internal Medicine) Physician (Internal Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207RA0201X

License number

29755 (GA)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-01-21

Last updated

2007-07-08