# OETTER FAMILY MEDICAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619343019
- **Authorized official:** KENDELL LYNN OETTER M.D. (PHYSICIAN)
- **Authorized official phone:** (219) 789-6704

## Contact information

- **Practice address:** 401 WALL ST, VALPARAISO, IN 46383-2521
- **Practice address phone:** (219) 281-1729
- **Mailing address:** 401 WALL ST, SUITE B, VALPARAISO, IN 46383-2521
- **Mailing address phone:** (219) 281-1729

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02001332A | IN | Yes |

## Other

- **Enumeration date:** 08/19/2015
- **Last updated:** 08/19/2015