Ottinger, Mary L
Ottinger, Mary L is an individual health care provider with primary practice located at 1515 Laney Walker Blvd , Augusta GA 30904-5827. She recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Radiology, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is her primary health care specialty. Ottinger, Mary L can be contacted via phone (706) 724-0586.Contact Information
Primary practice address
1515 Laney Walker Blvd
Augusta GA 30904-5827
Phone: (706) 724-0586
Fax: (706) 724-4468
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | GA520 | Georgia |
| Podiatric Medicine & Surgery Service Providers / Radiology | 213ER0200X | GA520 | Georgia |
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | GA520 | Georgia |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | GA520 | Georgia |
Profile Details
| NPI number | 1821149782 |
|---|---|
| LBN Legal business name | Ottinger, Mary L |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 16th, 2007 |
| Last updated | Jun 25th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821149782 | NPPES |
| South Carolina | MEDICAID | GPO520 | |
| South Carolina | Other | GA520 | |
| South Carolina | MEDICAID | 000314278C |
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