Individual
MADISON GENE OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 W MICHIGAN ST # CL630, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
Mailing address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-3294
(678) 312-3282
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
111186
GA
2084P0800X
Psychiatry Physician
Primary
LL86159
SC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
03/01/2026
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