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NPI Code Detail

MEDICARE: GUILLERMO A. ORTIZ SAN JUAN MD

MEDICARE: GUILLERMO A. ORTIZ SAN JUAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician35.142043OH

General Provider Information

NPI Number : 1083098784
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUILLERMO A. ORTIZ SAN JUAN MD
Provider Business Mailing Address
First Line : 700 ACKERMAN RD STE 2120
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1559
Country : US
Telephone Number : 614-293-6255
Fax Number : 614-293-1456
Provider Business Practice Location Address
First Line : 6700 UNIVERSITY BLVD
Second Line :
City : DUBLIN
State : OH
Zip : 43016-3508
Country : US
Telephone Number : 614-293-6255
Fax Number : 614-293-1456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2015
Last Update Date : 03/17/2026

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