Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 41264 | IA |
N | 208600000X | Surgeon | 41264 | IA |
N | 208200000X | Surgeon | 43768 | MN |
N | 208600000X | Surgeon | 43768 | MN |
Y | 2086S0102X | Surgical Critical Care | 43768 | MN |
N | 2086S0120X | Pediatric Surgery | 41264 | IA |
NPI | 1205808490 |
---|---|
Provider Name | Donald D Potter JR. |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 19/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H47739 | (02) |