Organization Name: | PHILLIP L. POTTER, MD, FACOG, PC |
NPI Number: | 1891835021 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PHILLIP POTTER (MEDICAL DIRECTOR) |
Mailing Address: | 1700 Hospital South Dr Suite 504 Austell |
State: | GA US |
Postal Code: | 301066810 |
Phone Number: | 7708198211 |
Fax Number: | 7708199616 |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 034220 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |