Ira B Potter Psc

LBN: Ira B Potter Psc
Ira B Potter Psc is an health care organization with primary practice located at 77 Millard Allen Dr. , Lackey KY 41643-0190. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Medical Specialty, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Ambulatory Health Care Facilities / Medical Specialty is the primary health care specialty. Ira B Potter Psc can be contacted via phone (606) 358-2381, or through Potter, Ira Blaine via phone (606) 358-2381.

Contact Information

Primary practice address
77 Millard Allen Dr. Lackey KY 41643-0190
Fax: (606) 358-2404
Website:
Authorized official contact:
Name: Potter, Ira Blaine Doctor of Medicine (MD)

Health care specialties

Profile Details

NPI number 1962401455
LBN Legal business name Ira B Potter Psc
DBA Doing business as
Authorized official Potter, Ira Blaine Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 18th, 2005
Last updated Mar 21st, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962401455 NPPES
Kentucky Other 000000057539 ANTHEM
Kentucky MEDICAID 65901399 ANTHEM

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