Provider Demographics
NPI:1558367797
Name:ELIZABETH H OTTMAN PSC
Entity Type:Organization
Organization Name:ELIZABETH H OTTMAN PSC
Other - Org Name:OHIO VALLEY OB GYN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:HAWKINS
Authorized Official - Last Name:OTTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-688-6035
Mailing Address - Street 1:2851 NEW HARTFORD RD
Mailing Address - Street 2:STE B
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1320
Mailing Address - Country:US
Mailing Address - Phone:270-688-6035
Mailing Address - Fax:270-688-6056
Practice Address - Street 1:2851 NEW HARTFORD RD
Practice Address - Street 2:STE B
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1320
Practice Address - Country:US
Practice Address - Phone:270-688-6035
Practice Address - Fax:270-688-6056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65900300Medicaid
KY0622401Medicare PIN