Provider Demographics
NPI:1699002972
Name:POTTEIGER, BETSY JO (PHARMD BCACP BCGP)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:JO
Last Name:POTTEIGER
Suffix:
Gender:F
Credentials:PHARMD BCACP BCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1752
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36547-1752
Mailing Address - Country:US
Mailing Address - Phone:928-566-4852
Mailing Address - Fax:
Practice Address - Street 1:698 S MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-3541
Practice Address - Country:US
Practice Address - Phone:251-971-6258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-07
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0159121835G0303X, 1835P2201X
PARP037060L1835G0303X, 1835P2201X
AL202461835P2201X, 1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care