Provider Demographics
NPI:1699349696
Name:POTTER, HANNAH PUCKETT (MD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:PUCKETT
Last Name:POTTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 TOWNE LAKE PKWY STE 404
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-1604
Mailing Address - Country:US
Mailing Address - Phone:770-721-9420
Mailing Address - Fax:678-445-2164
Practice Address - Street 1:900 TOWNE LAKE PKWY STE 404
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-1604
Practice Address - Country:US
Practice Address - Phone:770-721-9420
Practice Address - Fax:706-946-5074
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL86171207V00000X
GA104783207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology