Individual
DR. DOUGLAS E OTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2410 INGLESIDE AVE, MACON, GA 31204-2036
(478) 477-8996
Mailing address
109 PRESTON CT, MACON, GA 31210-5769
(478) 477-8996
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
AO9098294
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00255824E
—
GA
Enumeration date
05/04/2007
Last updated
11/08/2011
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