Individual
DR. RUSSELL JON OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1209 BENT OAKS CT, DENTON, TX 76210-3300
(940) 891-6100
(940) 891-6110
Mailing address
1209 BENT OAKS CT, DENTON, TX 76210-3300
(940) 891-6100
(940) 891-6110
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
K6206
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037103102
—
TX
Enumeration date
02/15/2006
Last updated
10/12/2011
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