Individual
OTHELLO R REPUYAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3814 JAMES CT, ZANESVILLE, OH 43701-0965
(740) 454-7119
(740) 455-5155
Mailing address
PO BOX 1821, ZANESVILLE, OH 43702-1821
(740) 455-3304
(740) 455-3686
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35041605R
OH
Other
Enumeration date
12/20/2005
Last updated
07/08/2007
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