Individual
DR. JOHN C OTTENBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8001 WEST 5TH STREET, BOWDLE, SD 57428
(605) 285-9832
(605) 285-6986
Mailing address
PO BOX 157, SELBY, SD 57472-0157
(605) 649-7366
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1128
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5604543
—
SD
01
—
7684
WELLMARK BC/BS OF SD
SD
01
—
9174905
DAKOTACARE
SD
Enumeration date
11/08/2006
Last updated
09/15/2016
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