Joe O Othman MD Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

15411 Issued in WV

Legal business name

JOE O OTHMAN MD INC

Practice address

RR 2 Box 169
Greyrock Profess. Park
Lewisburg, WV 24901-9316

Phone

(304) 647-3040

Fax

(304) 647-3835

NPI assigned

Mar 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Joe O Othman, MD

Title

President

Phone

(304) 647-3040

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1740305275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 169",
            "address_2": "GREYROCK PROFESS. PARK",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019316",
            "telephone_number": "304-647-3040",
            "fax_number": "304-647-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 169",
            "address_2": "GREYROCK PROFESS. PARK",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019316",
            "telephone_number": "304-647-3040",
            "fax_number": "304-647-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOE O OTHMAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "OTHMAN",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-647-3040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WV",
            "license": "15411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0089749000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "9268691",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Lewisburg, WV
• Providers in Lewisburg, WV by specialty
• Neurology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.