Individual
JAN A GOTTA
Active
Individual
JAN A GOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD2004-0691
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10016519
LOVELACE
NM
01
—
201050016
PRESBYTERIAN HP
NM
05
—
73670375
—
CO
05
—
77636554
—
NM
05
—
927494
—
AZ
01
—
NM009T46
BCBS
NM
01
—
P00201833
RR MEDICARE
NM
05
—
T0364
—
UT
Enumeration date
02/09/2006
Last updated
12/10/2009
Update your record
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