Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2014006166 | MO |
NPI | 1003013947 |
---|---|
Provider Name | Dr. Robert Joel Otto |
First Address | Nashville, TN 37203-1562 |
Second Address | Nashville, TN 37203-2385 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 12/01/2022 |