Provider Demographics
NPI:1780982512
Name:TORTORICH, JOSEPH WELLS (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WELLS
Last Name:TORTORICH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12188A N MERIDIAN ST STE 375
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4433
Mailing Address - Country:US
Mailing Address - Phone:317-926-1056
Mailing Address - Fax:317-806-2345
Practice Address - Street 1:12188A N MERIDIAN ST STE 375
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-926-1056
Practice Address - Fax:317-806-2345
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005382A207Y00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology