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NPI 1063750586

NPI 1063750586 : OTTUMWA HEALTH GROUP LLC : OTTUMWA, IA

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General NPI Number Information
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    NPI Number           |    1063750586
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    Entity Type          |    Organization 
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    Legal Business Name  |    OTTUMWA HEALTH GROUP LLC 
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Dates
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    Enumeration Date     |    01/17/2013
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    Last Update Date     |    09/26/2024
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Provider Practice Location Address
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    Address Line         |    1005 PENNSYLVANIA AVE STE 204
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    City                 |    OTTUMWA
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    State                |    IA
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    Zip                  |    52501-6413
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    Country              |    US
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    Telephone            |    641-682-8761
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    330 SEVEN SPRINGS WAY 
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    City                 |    BRENTWOOD
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    State                |    TN
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    Zip                  |    37027-5098
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    Country              |    US
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    Telephone            |    615-920-7000
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    Fax                  |    
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Authorized Official
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    Title or Position    |    SECRETARY
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    Name                 |     CHARLOTTE  LAWRENCE 
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    Credential           |    
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    Telephone            |    615-920-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363LX0001X
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    Taxonomy Name        |    Obstetrics & Gynecology Nurse Practitioner
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #5
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #6
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    Taxonomy Code        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    
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    License Number State |    
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