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Individual

DR. JOE O OTHMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
RR 2 BOX 169, GREYROCK PROFESS. PARK, LEWISBURG, WV 24901-9316
(304) 647-3040
(304) 647-3835
Mailing address
RR02 BOX 169, GREYROCK PROFESS. PARK, LEWISBURG, WV 24901-9316
(304) 647-3040
(304) 647-3835

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
15411
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0089749000
WV
Enumeration date
08/22/2005
Last updated
07/08/2007
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