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NPI Code Detail

MEDICARE: DR. MATTHEW LAWRENCE OTT D.O, MPH

MEDICARE: DR. MATTHEW LAWRENCE OTT D.O, MPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician2022028109MO

General Provider Information

NPI Number : 1295046613
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW LAWRENCE OTT D.O, MPH
Provider Business Mailing Address
First Line : 3027 PROSPECT AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64128-1530
Country : US
Telephone Number : 816-861-6500
Fax Number : 816-861-6503
Provider Business Practice Location Address
First Line : 3027 PROSPECT AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64128-1530
Country : US
Telephone Number : 816-861-6500
Fax Number : 816-861-6503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2010
Last Update Date : 01/18/2023

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