Individual
DR. RAYMOND JAMES OTTOMEYER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2011 HIGHWAY K, O FALLON, MO 63366-3965
(636) 379-5934
(636) 980-1059
Mailing address
199 FRONTIER PARK DR, O FALLON, MO 63366-3963
(636) 379-5934
(636) 410-3323
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006182
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19387
BLUECROSS PROVIDER NUMBER
MO
05
—
230079324
—
MO
01
—
248480
HEALTHLINK PROVIDER NUMBE
MO
01
—
5064408
AETNA PROVIDER NUMBER
MO
Enumeration date
08/23/2006
Last updated
02/24/2022
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