Organization
JOE O OTHMAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE O OTHMAN MD (PRESIDENT)
(304) 647-3040
Entity
Organization
Contact information
Practice address
RR 2 BOX 169, GREYROCK PROFESS. PARK, LEWISBURG, WV 24901-9316
(304) 647-3040
(304) 647-3835
Mailing address
RR 2 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
01
—
9268691
MEDICARE PTAN
WV
Enumeration date
03/21/2007
Last updated
09/25/2014
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