Individual
JACK F OTTENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
70 MEDICAL CENTER CIR, SUITE 110, FISHERSVILLE, VA 22939-2273
(540) 332-5850
(540) 332-5851
Mailing address
70 MEDICAL CENTER CIR, SUITE 110, FISHERSVILLE, VA 22939-2273
(540) 332-5850
(540) 332-5851
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101234631
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006410031
—
VA
Enumeration date
05/06/2006
Last updated
11/05/2012
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