| James M Ottesen Phd Inc | |
|
640 East 700 South Suite 207 St. George UT 84770-5293 | |
| (435) 652-0322 | |
| (435) 652-0350 |
| Full Name | James M Ottesen Phd Inc |
|---|---|
| Speciality | Psychologist |
| Location | 640 East 700 South, St. George, Utah |
| Authorized Official Name and Position | James M Ottesen (PRESIDENT) |
| Authorized Official Contact | 4356520322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James M Ottesen Phd Inc 640 East 700 South Suite 207 St. George UT 84770-5293 Ph: (435) 652-0322 | James M Ottesen Phd Inc 640 East 700 South Suite 207 St. George UT 84770-5293 Ph: (435) 652-0322 |
| NPI Number | 1720186307 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0446258305 |
|---|---|
| Medicare Enrollment ID | O20061201000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720186307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 325458-2501 (Utah) | Primary |
| Provider Name | James M Ottesen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831102490 PECOS PAC ID: 8729086681 Enrollment ID: I20061201000325 |
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