Larry O Otwell, AUD CCCA | |
2518 S Highway 77 Ste A, Lynn Haven, FL 32444-4730 | |
(850) 769-2705 | |
(850) 769-1097 |
Full Name | Larry O Otwell |
---|---|
Gender | Male |
Speciality | Audiologist |
Location | 2518 S Highway 77 Ste A, Lynn Haven, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417941329 | NPI | - | NPPES |
AD782 | Other | FL | MEDICARE GROUP |
K0176 | Other | FL | MEDICARE OLD PTAN |
S1844 | Other | FL | BCBS |
600185800 | Medicaid | FL | |
600237400 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | AY370 (Florida) | Primary |
Provider Name | Hometown Hearing Care |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1194212704 PECOS PAC ID: 9537403324 Enrollment ID: O20181205001712 |
Mailing Address | Practice Location Address |
---|---|
Larry O Otwell, AUD CCCA 2518 S Highway 77 Ste A, Lynn Haven, FL 32444-4730 Ph: (850) 769-2705 | Larry O Otwell, AUD CCCA 2518 S Highway 77 Ste A, Lynn Haven, FL 32444-4730 Ph: (850) 769-2705 |
Audiology Consultants Pa Of Panama City Audiologist Medicare: Medicare Enrolled Practice Location: 2518 S Highway 77 Ste A, Lynn Haven, FL 32444 Phone: 850-769-2705 Fax: 850-769-1097 | |
Marcus P Kolmetz, MA CCCA Audiologist Medicare: Accepting Medicare Assignments Practice Location: 2518 S Highway 77 Ste A, Lynn Haven, FL 32444 Phone: 850-769-2705 Fax: 850-769-1097 |