Kyle M Otteson, OD
Optometrist in Bismarck, ND. Individual provider (NPI-1).
NPI number1679907307
StatusActive
Last updated in NPPESDec 15, 2020
Details
- NPI
- 1679907307
- Entity type
- Individual (NPI-1)
- Name
- Kyle M Otteson
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 29, 2013
- Certification date
- Dec 15, 2020
- Last updated
- Dec 15, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 714 | ND | Yes |
Practice location
200 S 5th StBismarck, ND 58504-5675
Phone 701-222-3937 · Fax 701-222-8805
Mailing address
200 S 5th StBismarck, ND 58504-5675
Phone 701-222-3937 · Fax 701-222-8805
Other practice locations
3119 N 14th St
Bismarck, ND 58503-0664
Bismarck, ND 58503-0664
Phone 701-222-3937 · Fax 701-222-8805
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