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Individual

PAUL EIRIK OTTESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C

Contact information

Practice address
825 NE GATEWAY DR STE 148, GRIMES, IA 50111-1307
(515) 875-9766
(515) 875-9162
Mailing address
PO BOX 424, DES MOINES, IA 50302-0424
(515) 875-9255
(515) 875-9223

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-04519
NC
363A00000X
Physician Assistant
Primary
082773
IA
363A00000X
Physician Assistant
13358
MN

Other

Enumeration date
09/23/2013
Last updated
07/23/2025
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