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General NPI Number Information
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NPI Number | 1508842626
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Entity Type | Individual
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Provider Name | JOSE G URRUTIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2801 BAY PARK DR
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City | OREGON
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State | OH
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Zip | 43616-4920
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Country | US
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Telephone | 419-690-7746
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Fax | 419-697-7735
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Provider Business Mailing Address
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Address Line | 2341 CHRISWOOD RD
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City | TOLEDO
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State | OH
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Zip | 43617-1259
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Country | US
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Telephone | 419-841-4283
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Fax | 419-843-7197
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 35043427
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License Number State | OH
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