MEDICARE: DONALD J ORTIZ 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
1	208D00000X	General Practice Physician	92-323	NM
2	207Q00000X	Family Medicine Physician	92-323	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841309176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD J ORTIZ MD

Provider Business Mailing Address
First Line	:	PO BOX 26028
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87125-6028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1821 CARLISLE BLVD NE
Second Line	:	MIDTOWN FAMILY MEDICINE
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4905
Country	:	US
Telephone Number	:	505-255-1228
Fax Number	:	505-255-1394

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	10/29/2024

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Directions to “ DONALD J ORTIZ MD” Practice Location

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