Organization
OTTWELL DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN LUCAS OTTWELL DO (OWNER)
(918) 991-8718
Entity
Organization
Contact information
Practice address
3915 E 51ST ST, TULSA, OK 74135-3605
(918) 991-8718
Mailing address
6224 S 223RD EAST AVE, BROKEN ARROW, OK 74014-2029
(918) 991-8718
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/12/2025
Last updated
04/12/2025
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