Organization · Type 2 NPI
Ira B Potter PSC
Medical Specialty Clinic/Center · Lackey, KY
Practice location
77 Millard Allen Dr.
Lackey, KY 41643-0190
Fax (606) 358-2404
Mailing address
PO Box 190, 77 Millard Allen Drive
Lackey, KY 41643-0190
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center Primary | 261QM2500X | None listed |
| Physician Assistant | 363A00000X | PA1587 (KY) |
Medical Specialty Clinic/Center: 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 public health needs (e.g., infectious diseases or breast and cervical cancer).
About NPI 1962401455
Ira B Potter PSC's National Provider Identifier is 1962401455, issued on Jul 18, 2005. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Lackey, KY. The record was last updated on Mar 21, 2016.