MEDICARE: CHRIS OTTO PA

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
1	363AM0700X	Medical Physician Assistant	PA734	WY

General Provider Information

NPI Number	:	1982051850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS OTTO PA

Provider Business Mailing Address
First Line	:	3236 E GRAND AVE STE D
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82070-5100
Country	:	US
Telephone Number	:	307-760-8602
Fax Number	:	307-460-9880

Provider Business Practice Location Address
First Line	:	3236 E GRAND AVE STE D
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82070-5100
Country	:	US
Telephone Number	:	307-760-8602
Fax Number	:	307-460-9880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2016
Last Update Date	:	06/28/2023

Similar Medicare Providers

1477109445 — PHILIP LERORY SANDERS III FNP-C
Practice Location Address:

3236 E GRAND AVE STE D
LARAMIE, WY
82070-5100

Practice Phone: 307-760-8602
Practice Fax:

1215941638 — KURT S. JOHNSON, MD, PC
Practice Location Address:

3236 E GRAND AVE STE G
LARAMIE, WY
82070-5100

Practice Phone: 307-742-3242
Practice Fax: 307-742-3282

1831439108 — NICOLE N ALEXANDER PA-C
Practice Location Address:

3236 E GRAND AVE STE I
LARAMIE, WY
82070-5100

Practice Phone: 307-760-8602
Practice Fax: 307-288-6065

1497184378 — JOHN JACOBS III NP-C
Practice Location Address:

3236 E GRAND AVE STE D
LARAMIE, WY
82070-5100

Practice Phone: 307-760-8602
Practice Fax: 307-460-9880

1174983118 — GRAND AVENUE URGENT CARE, LLC
Practice Location Address:

3236 E GRAND AVE STE D
LARAMIE, WY
82070-5100

Practice Phone: 307-760-8602
Practice Fax:

1891346516 — CHRISTINA COOK PMHNP
Practice Location Address:

3236 E GRAND AVE STE I
LARAMIE, WY
82070-5100

Practice Phone: 307-760-8602
Practice Fax:

Directions to “ CHRIS OTTO PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.