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Contact Information

JON W POTTER, DO
4109 OAKWOOD HILLS PARKWAY
EAU CLAIRE, WI54701-8888
 Phone: 715-552-7303
 Fax: 715-552-7355
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for JON W POTTER · (Male)

NPI Number 1093785180
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 01/23/2006
Last updated 05/24/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • IA License # 04791
  • IL License # 036-132113
  • MI License # JP016277
  • WI License # 44787-021
  • MI Medicaid 4693501
  • WI Medicaid 43546500
  • MI Other 1055201131 BLUE CROSS BLUE SHIELD
  • MI Other P00165661 RAILROAD MEDICARE
Hospital affiliation(s)
  • OAK LEAF SURGCL HSPTL - (Acute Care)
    1000 OAKLEAF WAY
    ALTOONA, WI 54720
  • SACRED HEART HSPTL - (Acute Care)
    900 W CLAIREMONT AVE
    EAU CLAIRE, WI 54701
  • ST JOSEPHS HSPTL - (Acute Care)
    2661 COUNTY HWY I
    CHIPPEWA FALLS, WI 54729
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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