Dr. Jack Benson Potter, md
Internal Medicine, Allergy & Immunology in Atlanta, GA. Individual provider (NPI-1).
NPI number1073666087
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1073666087
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jack Benson Potter
- Credential
- md
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 21, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - INTERNAL MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RA0201X | Internal Medicine, Allergy & Immunology | 29755 | GA | Yes |
Practice location
960 Johnson Ferry Rd NeSuite 410
Atlanta, GA 30342-1631
Phone 404-256-3788 · Fax 404-847-9613
Mailing address
960 Johnson Ferry Rd NeSuite 410
Atlanta, GA 30342-1631
Phone 404-256-3788 · Fax 404-847-9613
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