Organization
DR RAYMOND J OTIS SR PC
Active
Other names
Camilla Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND J OTIS SR. MD (OWNER)
(229) 336-7343
Entity
Organization
Contact information
Practice address
24 N ELLIS ST, CAMILLA, GA 31730-1502
(229) 336-7343
(229) 336-7400
Mailing address
PO BOX 348, CAMILLA, GA 31730-0348
(229) 336-7343
(229) 336-7400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
42685
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0720266D
—
GA
Enumeration date
02/26/2008
Last updated
05/28/2024
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