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Individual
THOMAS EDWARD OTT
Active
Individual
THOMAS EDWARD OTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35066600
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000201372
ANTHEM
OH
05
—
0101893
—
OH
01
—
01823
PARAMOUNT
OH
01
—
080171614
RAILROAD MEDICARE
OH
05
—
104508050
—
MI
01
—
607055
BCHP
OH
Enumeration date
09/26/2006
Last updated
09/28/2011
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