Provider Demographics
NPI:1194065987
Name:RICHARD F JOTTE, INC.
Entity type:Organization
Organization Name:RICHARD F JOTTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:JOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-427-2022
Mailing Address - Street 1:10499 SAINT CHARLES ROCK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAINT ANN
Mailing Address - State:MO
Mailing Address - Zip Code:63074-1832
Mailing Address - Country:US
Mailing Address - Phone:314-427-2022
Mailing Address - Fax:314-427-6230
Practice Address - Street 1:10499 SAINT CHARLES ROCK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:SAINT ANN
Practice Address - State:MO
Practice Address - Zip Code:63074-1832
Practice Address - Country:US
Practice Address - Phone:314-427-2022
Practice Address - Fax:314-427-6230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9B59207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A11571Medicare UPIN