Healthcare Provider Details

I. General information

NPI: 1558367797
Provider Name (Legal Business Name): ELIZABETH H OTTMAN PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 NEW HARTFORD RD STE B
OWENSBORO KY
42303-1320
US

IV. Provider business mailing address

2851 NEW HARTFORD RD STE B
OWENSBORO KY
42303-1320
US

V. Phone/Fax

Practice location:
  • Phone: 270-688-6035
  • Fax: 270-688-6056
Mailing address:
  • Phone: 270-688-6035
  • Fax: 270-688-6056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH HAWKINS OTTMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 270-688-6035