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General NPI Number Information
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NPI Number | 1902813413
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Entity Type | Individual
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Provider Name | MARCO ANTONIO ORTEGA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 125 WESTBURY DR SW
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City | HUNTSVILLE
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State | AL
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Zip | 35802-1619
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Country | US
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Telephone | 256-937-9888
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 WHITESBURG DR STE 30 POST MAIL BOX 237
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City | HUNTSVILLE
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State | AL
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Zip | 35802
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Country | US
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Telephone | 256-937-1209
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Fax | 256-223-9247
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K6667
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01048083A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME75686
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 21406
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License Number State | AL
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