Provider Demographics
NPI:1013003748
Name:POTTS, DONALD M (MD)
Entity Type:Individual
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First Name:DONALD
Middle Name:M
Last Name:POTTS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2550 N THUNDERBIRD CIR
Mailing Address - Street 2:STE 303
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-1214
Mailing Address - Country:US
Mailing Address - Phone:480-435-9132
Mailing Address - Fax:480-776-0025
Practice Address - Street 1:1701 E THOMAS RD
Practice Address - Street 2:STE A104
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7646
Practice Address - Country:US
Practice Address - Phone:602-845-4445
Practice Address - Fax:602-277-9360
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2017-03-16
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Provider Licenses
StateLicense IDTaxonomies
SD1567207Q00000X
AZ53714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5605665Medicaid