Provider Demographics
NPI:1649416074
Name:APPALACHIAN HEALTHCARE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:APPALACHIAN HEALTHCARE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-679-0800
Mailing Address - Street 1:338 COEBURN AVE SW
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-2606
Mailing Address - Country:US
Mailing Address - Phone:276-679-0800
Mailing Address - Fax:276-679-0097
Practice Address - Street 1:338 COEBURN AVE SW
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-2606
Practice Address - Country:US
Practice Address - Phone:276-679-0800
Practice Address - Fax:276-679-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232468207KA0200X, 2080A0000X
VA0102201836207RA0000X, 2080A0000X
VA0102201378207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Multi-Specialty