Virgil V Ottun, M.D.

Individual provider Active NPI General Practice Physician · Sargent, NE

NPI 1043583560 · NPPES record last updated Feb 14, 2012

Key facts

NPI
1043583560
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
13905 (NE)
Practice address
81084 Round Valley Rd
Sargent, NE 68874-3119
Phone
(308) 527-3974
NPI assigned
Feb 14, 2012
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13905NEMDGeneral Practice Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 13905 NE Yes

Addresses

Primary practice location

81084 Round Valley Rd
Sargent, NE 68874-3119

Mailing address

81084 Round Valley Rd
Sargent, NE 68874-3119
Phone (308) 527-3974

Other providers in Sargent, NE

All providers in Sargent, NE · General Practice Physician in Nebraska

Sources for this page

Verify at the official NPI Registry.