JERRY LYNN POTTS MD

Allergy and Immunology

Pine Bluff, Arkansas

Provider NPI: 1447226477

Provider Information:
 JERRY LYNN POTTS MD


Practice Location:
1408 W 43RD AVE  PINE BLUFF, AR 71603 US
Tel: 870-535-5719  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	207K00000X	Physicians Allergy & Immunology	AR	C4520
N	207KA0200X	Physicians Allergy & Immunology	AR	C4520
Y	207Y00000X	Physicians Otolaryngology	AR	C4520

Other Provider Identifiers:

Issuer	Number	State	Type
ARKANSAS BLUE CROSS BLUE SHIELD	54134	AR	01
	104787001	AR	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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