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1740565902 NPI number — DEBORAH KAY OTT MS

NPI Number: 1740565902
Health Care Provider/Practitioner: DEBORAH KAY OTT MS

Information about “1740565902” NPI (DEBORAH KAY OTT MS) exists in 1740565902 in HTML format HTML  |  1740565902 in plain Text format TXT  |  1740565902 in PDF (Portable Document Format) PDF  |  1740565902 in an XML format XML  formats.

NPI Number : 1740565902 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740565902",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OTT",
    "FirstName": "DEBORAH",
    "MiddleName": "KAY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "41 LYNNWOOD RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HARTSHORNE",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "74547-5164",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "918-448-4432",
    "MailingAddressFaxNumber": "918-297-3701",
    "FirstLinePracticeLocationAddress": "310 S 10TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HARTSHORNE",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "74547-4212",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "918-297-3700",
    "PracticeLocationAddressFaxNumber": "918-297-3701",
    "EnumerationDate": "10/19/2011",
    "LastUpdateDate": "04/01/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "175T00000X",
        "TaxonomyName": "Peer Specialist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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