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General NPI Number Information
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NPI Number | 1326602152
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Entity Type | Individual
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Provider Name | CLARISSA ASHLEY ORTIZ MD
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Gender | Female
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Dates
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Enumeration Date | 04/26/2019
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 601 ROSARY DR
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City | CORNING
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State | IA
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Zip | 50841-1683
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Country | US
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Telephone | 644-322-5245
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Fax | 644-322-4687
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Provider Business Mailing Address
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Address Line | 601 ROSARY DR
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City | CORNING
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State | IA
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Zip | 50841-1683
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Country | US
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Telephone | 644-322-5245
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Fax | 644-322-4687
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA11966800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD-55450
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License Number State | IA
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