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OTHON WILTZ M.D. NPI 1174525869


NPI Information

NPI: 1174525869
Provider Name: OTHON WILTZ, M.D.
Classification: Colon & Rectal Surgery - 208C00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3620 JOSEPH SIEWICK DR STE 406
FAIRFAX, VA
ZIP 22033
Phone: (703) 359-8640
Get Directions

Othon Wiltz, M.D. is a colon rectal surgery in Fairfax, VA with 39 years of experience. The provider is a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. Othon Wiltz, M.D. NPI is 1174525869. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Graduation Year:1985

The provider's business location address is:

3620 JOSEPH SIEWICK DR STE 406
FAIRFAX, VA
ZIP 22033-761
Phone: (703) 359-8640
Fax: (703) 591-6105

The NPI 1174525869 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/11/2005 and was last updated on 7/25/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208C00000XColon & Rectal Surgery11687PUERTO RICONo
2208C00000XColon & Rectal Surgery0101240155VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11174525869MEDICAIDVIRGINIA
2601049OTHERPUERTO RICOMMM
3SE4019OTHERPUERTO RICOPALIC
47113OTHERPUERTO RICOIMC
5060957OTHERPUERTO RICOLA CRUZ AZUL
689937OTHERPUERTO RICOSSS
71400005OTHERPUERTO RICOHUMANA
8311678OTHERPUERTO RICOCIGNA
9F50723MEDICARE UPINPUERTO RICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.