Otto, Raymond J

Otto, Raymond J is an individual health care provider with primary practice located at 600 Robbins Rd , Boise ID 83702. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine. Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine is his primary health care specialty. Otto, Raymond J can be contacted via phone (208) 489-5800.

Contact Information

Primary practice address
600 Robbins Rd Boise ID 83702
Phone: (208) 489-5800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X M-9590 Idaho
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 207PE0005X M-9590 Idaho

Profile Details

NPI number 1063455301
LBN Legal business name Otto, Raymond J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Aug 3rd, 2018 - about 7 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 1063455301 NPPES
Idaho MEDICAID 807447900

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