Louis-Jacques, Otto

Louis-Jacques, Otto is an individual health care provider with primary practice located at 3022 Williams Dr Suite 301, Fairfax VA 22031-4600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Louis-Jacques, Otto can be contacted via phone (703) 698-1775.

Contact Information

Primary practice address
3022 Williams Dr Suite 301 Fairfax VA 22031-4600
Phone: (703) 698-1775
Fax: (703) 641-8427
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 0101233886 Virginia

Profile Details

NPI number 1124094933
LBN Legal business name Louis-Jacques, Otto
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Mar 25th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124094933 NPPES
Virginia MEDICAID 6738052

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