Individual
STEPHEN ALLISON ORTLIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
606 N THOMAS ST, SOUTH HILL, VA 23970-1422
(434) 447-3651
(434) 447-2657
Mailing address
PO BOX 623, SOUTH HILL, VA 23970-0623
(434) 447-3651
(434) 447-2657
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101252671
VA
208800000X
Urology Physician
20400
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100173010A
—
OK
01
—
340015276
RAILROAD MEDICARE
OK
01
—
4044512
AETNA
OK
Enumeration date
08/10/2005
Last updated
12/10/2014
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