Healthcare Provider Details

I. General information

NPI: 1306237979
Provider Name (Legal Business Name): BRITTANY MARIE WOOTTEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2015
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL OKINAWA CHATAN, NAKAGAMI DISTRICT, OKINAWA , JAPAN
FPO AP
00904
US

IV. Provider business mailing address

3MED BN, 3MLG UNIT 38445
FPO AP
96373-8445
US

V. Phone/Fax

Practice location:
  • Phone: 703-398-5408
  • Fax:
Mailing address:
  • Phone: 703-398-5408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01094732A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101261175
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: