Individual
EUGENE E OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-5000
Mailing address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
293-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42945400
—
WI
Enumeration date
08/17/2006
Last updated
08/13/2009
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