Individual
DR. ROGER KEITH OTTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1512 12TH AVE RD, NAMPA, ID 83686-6008
(208) 463-5100
Mailing address
1100 RIVER HEIGHTS DR, MERIDIAN, ID 83642-5166
(208) 841-1814
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-3812
ID
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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