Individual
TODD W OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
801 MEDICAL DR, SUITE A, LIMA, OH 45804-4099
(419) 222-6622
(419) 224-0015
Mailing address
801 MEDICAL DR, SUITE A, LIMA, OH 45804-4099
(419) 222-6622
(419) 224-0015
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50001718
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000491275
ANTHEM
—
Enumeration date
03/09/2006
Last updated
04/06/2010
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