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Individual

LEANDRITA F ORTEGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1401 10TH ST, SUITE A, ALAMOGORDO, NM 88310-5012
(575) 434-5195
(575) 434-5790
Mailing address
250 1ST ST, ALAMOGORDO, NM 88310-6517
(575) 434-5195
(575) 434-5790

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23586
OK
207Q00000X
Family Medicine Physician
Primary
MD2012-0047
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200046270A
OK
05
79805361
NM
Enumeration date
01/27/2006
Last updated
11/01/2019
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