Dr. Jack Benson Potter
Internist - Allergy & Immunology
960 Johnson Ferry Rd Ne Suite 410
Atlanta
, Georgia 30342-1631
Dr. Jack Benson Potter
Internist - Allergy & Immunology
960 Johnson Ferry Rd Ne Suite 410
Atlanta
, Georgia 30342-1631
(404) 847-9613
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About
Features
Specialties
- Internist - Allergy & Immunology
Languages spoken
- English
Location
First Address
- Dr. Jack Benson Potter
- 960 Johnson Ferry Rd Ne Suite 410
- Atlanta, GA
- Zip : 30342-1631
- Fax : (404) 847-9613
- Phone : (404) 256-3788
Second Address
- Dr. Jack Benson Potter
- 960 Johnson Ferry Rd Ne Suite 410
- Atlanta, GA
- Zip : 30342-1631
- Fax : (404) 847-9613
- Phone : (404) 256-3788
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RA0201X | Internist - Allergy & Immunology | 29755 | GA |
National Provider Identifier
| NPI | 1073666087 |
|---|---|
| Provider Name | Dr. Jack Benson Potter |
| First Address | Atlanta, GA 30342-1631 |
| Second Address | Atlanta, GA 30342-1631 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/01/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C69367 | (02) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.