Potts, Jerry Lynn
Potts, Jerry Lynn is an individual health care provider with primary practice located at 1408 W 43Rd Ave , Pine Bluff AR 71603-7010. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Allergy, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Potts, Jerry Lynn can be contacted via phone (870) 535-5719.Contact Information
Primary practice address
1408 W 43Rd Ave
Pine Bluff AR 71603-7010
Phone: (870) 535-5719
Fax: (870) 536-1963
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | C4520 | Arkansas |
| Allopathic & Osteopathic Physicians / Allergy | 207KA0200X | C4520 | Arkansas |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | C4520 | Arkansas |
Profile Details
| NPI number | 1447226477 |
|---|---|
| LBN Legal business name | Potts, Jerry Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2006 |
| Last updated | Aug 21st, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447226477 | NPPES |
| Arkansas | Other | 54134 | ARKANSAS BLUE CROSS BLUE SHIELD |
| Arkansas | MEDICAID | 104787001 | ARKANSAS BLUE CROSS BLUE SHIELD |
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