Individual
BRADLEY A. OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
915 OLENTANGY RIVER RD STE 4000, COLUMBUS, OH 43212-3154
(614) 366-3687
(614) 293-6176
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-2594
(614) 293-4487
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35084019
OH
208600000X
Surgery Physician
35084019
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2539971
—
OH
Enumeration date
06/12/2006
Last updated
02/09/2021
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