JERRY LYNN POTTS (NPI# 1447226477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447226477 |
| Entity Type | Individual |
| Full Name | JERRY LYNN POTTS |
| Credential | MD |
| Practice Address |
1408 W 43rd Ave Pine Bluff AR 71603-7010 |
| Practice Telephone | 8705355719 |
| Practice Fax Number | 8705361963 |
| Mailing Telephone | 8705355719 |
| Mailing Fax Number | 8705361963 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2008-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | C4520 | AR | Allopathic & Osteopathic Physicians |
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
C4520 | AR | Allopathic & Osteopathic Physicians |
| Y | 207Y00000X | Otolaryngology | C4520 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | ARKANSAS BLUE CROSS BLUE SHIELD | 54134 | 01 |
| AR | 104787001 | 05 |
| Street Address |
1408 W 43RD AVE |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-7010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982065942 | Stephanie Smith | Audiologist | 1408 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2016-03-17 |
| 1679861330 | Deanne L. King | Otolaryngology | 1408 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2011-07-15 |
| 1700190311 | Alisa Kosmitis | Audiologist | 1408 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2010-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679861330 | Deanne L. King | Otolaryngology | 1408 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2011-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134608961 | Baptist Health Services | Otolaryngology | 520 Towson Ave, Suite A, Fort Smith, AR 72901 | 2018-08-13 |
| 1992125850 | White River Health System, Inc. | Otolaryngology | 501 Virginia Dr Ste A, Batesville, AR 72501-7317 | 2014-04-18 |
| 1437590080 | John R Sims | Otolaryngology | 8901 Carti Way Ste 201, Little Rock, AR 72205-6523 | 2013-07-11 |
| 1467726539 | William Rolland Eddington | Otolaryngology | 2564 Greene Road 739, Paragould, AR 72450-8859 | 2012-03-06 |
| 1558650960 | Graham Michael Strub | Otolaryngology | 1 Childrens Way # 836, Little Rock, AR 72202-3500 | 2011-04-06 |
| 1346478484 | Family Ent & Sinus Center of Harrison, P.a. | Otolaryngology | 1401 Mccoy Drive, Harrison, AR 72601-2417 | 2009-06-28 |
| 1376760215 | Robert Vernon Borg | Otolaryngology | 214 Leigh Cir, Hot Springs, AR 71901-7758 | 2007-04-20 |
| 1225170376 | Jason A Smith | Otolaryngology | 4901 Fairway Ave, Suite C, North Little Rock, AR 72116-6923 | 2007-02-13 |
| 1689730459 | Gordon Carl Shipp | Otolaryngology | 4301 W Markham St # 543, Little Rock, AR 72205-7101 | 2006-12-28 |
| 1275605206 | Sharon Marie Tomaski | Otolaryngology | 620 W Grove St Ste 201, El Dorado, AR 71730-4425 | 2006-11-14 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.