Organization · Type 2 NPI

Fred E. Potts, Iv, Md, LLC

Non-Pharmacy Dispensing Site · St. Joseph, MO

NPI number 1467704890 Active

Practice location

4906 Frederick Ave
St. Joseph, MO 64506-3246

Call (816) 233-3700 Map

Mailing address

2980 N Beverly Glen Cir, Suite 301
Los Angeles, CA 90077-1726

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	None listed

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

Another provider at this address

Sameer Gupta, MDPhlebology Physician St. Joseph, MO NPI 1043293996

NPI record

NPI: 1467704890
Entity type: Organization (Type 2)
Issued: Oct 9, 2012
Last updated: Oct 9, 2012
Status: Active
Subpart: Yes of Fred E. Potts, Iv, Md, LLC

Other names

<unavail>
Covenant Primary Care · doing business as

Authorized official

Dr. Fred E. Potts, MD
Medical Director
(816) 233-3700

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1467704890

Fred E. Potts, Iv, Md, LLC's National Provider Identifier is 1467704890, issued on Oct 9, 2012. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in St. Joseph, MO. The record was last updated on Oct 9, 2012.