Mr. Samuel E. Potts
Podiatrist Radiology Foot Surgery
2 Memorial Dr Suite 201
Decatur
, Illinois 62526-3950
Mr. Samuel E. Potts
Podiatrist Radiology Foot Surgery
2 Memorial Dr Suite 201
Decatur
, Illinois 62526-3950
(217) 428-7721
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About
Features
Specialties
- Podiatrist
- Radiology
- Foot Surgery
Languages spoken
- English
Location
First Address
- Mr. Samuel E. Potts
- 2 Memorial Drive Suite 201
- Decatur, IL
- Zip : 62526
- Phone : (217) 428-7721
Second Address
- Mr. Samuel E. Potts
- 2 Memorial Dr Suite 201
- Decatur, IL
- Zip : 62526-3950
- Fax : (217) 875-7710
- Phone : (217) 875-6980
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FAQs
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Is Mr. Samuel E. Potts a sole practitioner?
Is Mr. Samuel E. Potts accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 016004684 | IL |
| Y | 222Z00000X | Podiatrist | 016004684 | IL |
| N | 111NR0200X | Radiology | 016004684 | IL |
| N | 213ER0200X | Radiology | 016004684 | IL |
| N | 213ES0131X | Foot Surgery | 016004684 | IL |
National Provider Identifier
| NPI | 1326058447 |
|---|---|
| Provider Name | Mr. Samuel E. Potts |
| First Address | Decatur, IL 62526 |
| Second Address | Decatur, IL 62526-3950 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/08/2006 |
| Last Update Date | 05/11/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 230121 | HEALTHLINK (01) | |
| 480014432 | PALMETTA GBA-RR MEDICARE (01) | |
| 5805819 | BLUE CROSS BLUE SHIELD (01) | IL |
| U42154 | (02) |
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.