Provider Demographics
NPI:1093501306
Name:POTTER ORTHOPEDICS
Entity type:Organization
Organization Name:POTTER ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDEN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:940-636-4200
Mailing Address - Street 1:7522 SW 45TH AVE SPC 200
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-5036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7522 SW 45TH AVE SPC 200
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-5036
Practice Address - Country:US
Practice Address - Phone:940-636-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty