DR. JACK BENSON POTTER MD NPI 1073666087

NPI Information

  • NPI: 1073666087
  • Provider Name: DR. JACK BENSON POTTER, MD
  • Classification: Internal Medicine - 207RA0201X
  • Specialization: Allergy & Immunology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 960 JOHNSON FERRY RD NE
    SUITE 410
    ATLANTA, GA
    ZIP 30342
  • Phone: (404) 256-3788

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NPI Details

DR. Jack Benson Potter, MD is an allergy and immunology internal medicine in Atlanta, GA. The provider is an internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology. DR. Jack Benson Potter, MD NPI is 1073666087. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

960 JOHNSON FERRY RD NE
SUITE 410
ATLANTA, GA
ZIP 30342-631
Phone: (404) 256-3788
Fax: (404) 847-9613

The NPI 1073666087 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/21/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RA0201XInternal MedicineAllergy & Immunology29755GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C69367MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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