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Individual

MR. MARCUS RENE ORTIZ JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1450 DOWELL SPRINGS BLVD STE 210, KNOXVILLE, TN 37909-2448
(865) 524-2547
(865) 205-5601
Mailing address
PO BOX 23329, NEW YORK, NY 10087-3329

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
PA21940
CA
363A00000X
Physician Assistant
Primary
PA3923
TN
363AM0700X
Medical Physician Assistant
PA21940
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q050882
TN
Enumeration date
10/19/2011
Last updated
04/07/2026
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