Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35.126395 | OH |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 57105 | TN |
NPI | 1174967368 |
---|---|
Provider Name | Dr. Jeffrey Edward Otte |
First Address | Lima, OH 45804-4030 |
Second Address | Lima, OH 45804-4030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2013 |
Last Update Date | 06/06/2019 |