Provider Demographics
NPI:1649463407
Name:OTTEN, RYAN JORDAN (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JORDAN
Last Name:OTTEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4900 S MONACO ST STE 210
Mailing Address - Street 2:#C
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3487
Mailing Address - Country:US
Mailing Address - Phone:303-292-0034
Mailing Address - Fax:303-292-0097
Practice Address - Street 1:9195 GRANT ST STE 100
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4386
Practice Address - Country:US
Practice Address - Phone:303-292-0034
Practice Address - Fax:303-292-0097
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2016-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO480322083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine