Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01077903A | IN |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | TP531 | KY |
NPI | 1083971048 |
---|---|
Provider Name | Dr. Perry Stephen Poteet |
First Address | Fort Thomas, KY 41075-1765 |
Second Address | Fort Thomas, KY 41075-4107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 01/10/2018 |