Ira B Potter Psc in Lackey - Medical Specialty
Ira B Potter Psc - NPI 1962401455
Ira B Potter Psc is a Medical Specialty in Lackey, Kentucky. Ira B Potter Psc practices all healthcare services and medical treatments related to Medical Specialty. The NPI Number for Ira B Potter Psc is 1962401455. The last update date is 2016-03-21.
Ira B Potter Psc's current location address is Po Box 190, Lackey, Kentucky. You can contact this provider via phone number 6063582381 and fax number 6063582404. The mailing address for Ira B Potter Psc is Po Box 190, Lackey, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Ira B Potter Psc |
|---|---|
| Address | Po Box 190, Lackey, Kentucky |
| Phone Number | 6063582381 |
| Fax Number | 6063582404 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Potter Blaine Ira |
| Credentials | MD |
| Telephone Number | 6063582381 |
NPI Number Detail
| NPI Number | 1962401455 |
|---|---|
| Provider Enumeration Date | 2005-07-18 |
| Last Updated Date | 2016-03-21 |
Provider Mailing Address Detail
| Address | Po Box 190 |
|---|---|
| City | Lackey |
| State | Kentucky (KY) |
| Post Code | 416430190 |
| Phone Number | 6063582381 |
| Fax Number | 6063582404 |
Provider's Primary Taxonomy Detail
| Speciality | Medical Specialty |
|---|---|
| Taxonomy | 261Qm2500X |
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Definition: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 57539 | KY | ANTHEM | |
| 65901399 | KY | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Ira B Potter Psc by the Centers for Medicare & Medicaid Services?
The Ira B Potter Psc has been assigned the NPI (National Provider Identifier) 1962401455 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Ira B Potter Psc is physically located?
The Ira B Potter Psc is situated at the following address: Po Box 190, Lackey, KY 416430190.
What is Ira B Potter Psc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Ira B Potter Psc is Medical Specialty, and the taxonomy code that classifies this field of practice is 261Qm2500X.
On what date did Ira B Potter Psc receive its 1962401455 assignment from the Centers for Medicare & Medicaid Services?
The Ira B Potter Psc was assigned its 1962401455 on 2005-07-18, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Ira B Potter Psc most recently updated or revised?
The information pertaining to Ira B Potter Psc, including its address, specialty, and other relevant details, was last updated or revised on 2016-03-21.