| Andrew Ott | |
|
402 N. Washington St. Columbia City IN 46725 | |
| (260) 244-7413 | |
| (260) 387-6984 |
| Full Name | Andrew Ott |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 402 N. Washington St., Columbia City, Indiana |
| Authorized Official Name and Position | J Andrew Ott (SOLE MEMBER) |
| Authorized Official Contact | 2603876340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew Ott 402 N. Washington St. Columbia City IN 46725 Ph: (260) 244-7413 | Andrew Ott 402 N. Washington St. Columbia City IN 46725 Ph: (260) 244-7413 |
| NPI Number | 1467908012 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 09/01/2016 |
| Medicare PECOS PAC ID | 4284917543 |
|---|---|
| Medicare Enrollment ID | O20170210000982 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467908012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 34005694A (Indiana) | Primary |
| Provider Name | J Andrew Ott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184851537 PECOS PAC ID: 7315088622 Enrollment ID: I20100108000618 |
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