Provider Demographics
NPI:1770730707
Name:POTTS, JOSEPH LEE (USAF IDMT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LEE
Last Name:POTTS
Suffix:
Gender:M
Credentials:USAF IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3617 CALVERT ST
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2669
Mailing Address - Country:US
Mailing Address - Phone:210-792-5074
Mailing Address - Fax:
Practice Address - Street 1:485 QUENTIN ROOSEVELT RD
Practice Address - Street 2:SUITE 2
Practice Address - City:KELLY USA
Practice Address - State:TX
Practice Address - Zip Code:78226-1865
Practice Address - Country:US
Practice Address - Phone:210-925-5177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians