Healthcare Provider Details
I. General information
NPI: 1891881223
Provider Name (Legal Business Name): KARLA J WOTTGE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/05/2006
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
730 COOL SPRING BLVD EVICORE BY EVERNORTH SUITE 800
FRANKLIN TN
37067
US
IV. Provider business mailing address
730 COOL SPRING BLVD EVICORE BY EVERNORTH SUITE 800
FRANKLIN TN
37067
US
V. Phone/Fax
- Phone: 800-918-8924
- Fax:
- Phone: 800-918-8924
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | D025292 |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD25292 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: