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Individual

DR. JAMES JOHN OTREMBIAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
525 ALEXANDRIA PIKE STE 320, SOUTHGATE, KY 41071
(859) 781-1310
(859) 572-3021
Mailing address
525 ALEXANDRIA PIKE STE 320, SOUTHGATE, KY 41071-3243
(859) 781-1310
(859) 572-3021

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22676
KY
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64226764
KY
Enumeration date
01/23/2007
Last updated
07/06/2018
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