Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SAM CLAYTON POTTER
Active Sole ProprietorSAM CLAYTON POTTER is a Community/Behavioral Health healthcare provider located in SURPRISE, Arizona. NPI 1720500903 is currently active in the NPPES registry. Verify at CMS.
Community/Behavioral Health · SURPRISE, AZ
Registration Details
- NPI Number
- 1720500903
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 10, 2017 (9.0917789550165 yrs)
- Last Updated
- Jul 10, 2017
- Sole Proprietor
- Yes
Practice Information
- Address
-
16107 N 165TH LNSURPRISE, AZ, 853881141Browse AZ providers · Browse ZIP 85388
- Phone
- 6233372511
- Primary Specialty
-
Community/Behavioral Health
251S00000X
Other Community/Behavioral Health Providers in SURPRISE, AZ
| Name | Credential | NPI |
|---|---|---|
| JEREMIAH RASHAD JACKSON | — | 1588315980 |
| SAB EDWARDS | CNA | 1134803265 |
| JESSICA CORTINAS | — | 1083481089 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.