Provider Demographics
NPI:1942240254
Name:OTTS, RICHARD LEMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEMUEL
Last Name:OTTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MOBILE INFIRMARY CIR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3514
Mailing Address - Country:US
Mailing Address - Phone:251-433-1887
Mailing Address - Fax:251-433-1929
Practice Address - Street 1:3 MOBILE INFIRMARY CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3514
Practice Address - Country:US
Practice Address - Phone:251-433-1887
Practice Address - Fax:251-433-1929
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00007709174400000X
AL7709207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0552570001OtherMEDICARE
AL0552570001OtherCIGNA
AL51534439OtherBLUE CROSS
AL528902340Medicaid
AL51534439Medicare PIN
AL0552570001OtherMEDICARE