| Ottomeyer Clinics | |
|
1440 Duckwood Dr Ste 200 Eagan MN 55122-1451 | |
| (651) 203-4673 | |
| (651) 203-5130 |
| Full Name | Ottomeyer Clinics |
|---|---|
| Speciality | Clinic/Center |
| Location | 1440 Duckwood Dr Ste 200, Eagan, Minnesota |
| Authorized Official Name and Position | Grant Pylkas (CHAIRMAN) |
| Authorized Official Contact | 6512385558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ottomeyer Clinics 1440 Duckwood Dr Ste 200 Eagan MN 55122-1451 Ph: (651) 203-4673 | Ottomeyer Clinics 1440 Duckwood Dr Ste 200 Eagan MN 55122-1451 Ph: (651) 203-4673 |
| NPI Number | 1467403030 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 01/12/2022 |
| Certification Date | 01/12/2022 |
| Medicare PECOS PAC ID | 9234179664 |
|---|---|
| Medicare Enrollment ID | O20050505000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467403030 | NPI | - | NPPES |
| 24D2153873 | Other | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
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