Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Devon Potler-Jack

Individual provider Anesthesiologist Assistant · NPI 1578180535

Devon Potler-Jack is an Anesthesiology Assistant in Marietta, Georgia. Qualified in 2020, 6 years ago. Practices with Mak Anesthesia Holdings, LLC, a 368-clinician group.

Years since qualifying
6
In the registry since
2020
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Practice location Address checks out

677 Church St NE
Marietta, GA 30060-1101
Phone: (770) 793-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X

Record details

NPI number1578180535
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 25, 2020
Last updated in NPPESJune 25, 2020
Certification dateJune 25, 2020
Mailing address982 Virginia Ave Ne Apt 2, Atlanta, GA 30306-3608

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Mak Anesthesia Holdings, Llc — 368 clinicians
Accepts Medicare assignment Not indicated
Practice locations5 on file with Medicare

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