Provider Demographics
NPI:1760457634
Name:ORTIZ, JOSE F (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:F
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 MAIN
Mailing Address - Street 2:
Mailing Address - City:COLSTRIP
Mailing Address - State:MT
Mailing Address - Zip Code:59323-1858
Mailing Address - Country:US
Mailing Address - Phone:406-748-3600
Mailing Address - Fax:406-748-3606
Practice Address - Street 1:6230 MAIN
Practice Address - Street 2:
Practice Address - City:COLSTRIP
Practice Address - State:MT
Practice Address - Zip Code:59323-1858
Practice Address - Country:US
Practice Address - Phone:406-748-3600
Practice Address - Fax:406-748-3606
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0014348Medicaid
MT0014348Medicaid