Provider Demographics
NPI:1790768950
Name:OTTLEY, BARBARA-JEAN LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA-JEAN
Middle Name:LEWIS
Last Name:OTTLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212B E 27TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2112
Mailing Address - Country:US
Mailing Address - Phone:785-628-7600
Mailing Address - Fax:785-628-7601
Practice Address - Street 1:1212B E 27TH ST STE 1
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2112
Practice Address - Country:US
Practice Address - Phone:785-628-7600
Practice Address - Fax:785-628-7601
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS25115174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100172360BMedicaid
KS101747OtherBLUE CROSS BLUE SHIELD
KS100172360BMedicaid
KS101747OtherBLUE CROSS BLUE SHIELD