Provider Demographics
NPI:1679228894
Name:JJ OTTING LLC
Entity Type:Organization
Organization Name:JJ OTTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:OTTING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:567-408-7703
Mailing Address - Street 1:5085 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3455
Mailing Address - Country:US
Mailing Address - Phone:567-408-7703
Mailing Address - Fax:419-754-2311
Practice Address - Street 1:5085 MONROE ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3455
Practice Address - Country:US
Practice Address - Phone:567-408-7703
Practice Address - Fax:419-754-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty