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Individual

ADAM PHILLIP OTWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
398 DIEDERICH BLVD, ASHLAND, KY 41101-7008
(606) 324-2055
(606) 326-1159
Mailing address
PO BOX 4190, BARBOURSVILLE, WV 25504-4190
(304) 908-9201

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.005730RX
OH
363A00000X
Physician Assistant
Primary
TC379
KY

Other

Enumeration date
03/19/2019
Last updated
08/07/2023
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