Provider Demographics
NPI:1770589970
Name:OTTMAN, ELIZABETH HAWKINS (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HAWKINS
Last Name:OTTMAN
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2211 MAYFAIR DR
Mailing Address - Street 2:STE 301
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-4569
Mailing Address - Country:US
Mailing Address - Phone:270-688-6035
Mailing Address - Fax:270-688-6056
Practice Address - Street 1:2211 MAYFAIR DR
Practice Address - Street 2:STE 301
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-4569
Practice Address - Country:US
Practice Address - Phone:270-688-6035
Practice Address - Fax:270-688-6056
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2012-09-24
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Provider Licenses
StateLicense IDTaxonomies
KY27321207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64273212Medicaid
KY64273212Medicaid
KYF68205Medicare UPIN