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General NPI Number Information
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NPI Number | 1366495160
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Entity Type | Individual
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Provider Name | RICK ARLIN OTWELL PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 1612 HIGHWAY 78 EAST SUITE 100
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City | OXFORD
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State | AL
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Zip | 36203-5862
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Country | US
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Telephone | 256-835-4756
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Fax | 256-831-5736
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Provider Business Mailing Address
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Address Line | 7306 WEATHERFORD TRCE
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City | TRUSSVILLE
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State | AL
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Zip | 35173-5111
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Country | US
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Telephone | 205-661-3938
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Fax | 205-661-3938
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA-216
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License Number State | AL
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