Provider Demographics
NPI:1689732299
Name:POTTS, ELLEN KLEPZIG (DO)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:KLEPZIG
Last Name:POTTS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 CASTLE BLVD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6534
Mailing Address - Country:US
Mailing Address - Phone:330-836-5587
Mailing Address - Fax:
Practice Address - Street 1:659 BOULEVARD
Practice Address - Street 2:UNION HOSPITAL
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622
Practice Address - Country:US
Practice Address - Phone:330-364-0844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076802B207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine