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Individual

PUBLIO ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
146 W DALE ST, SUITE 102, WATERLOO, IA 50703-1901
(319) 235-5050
(319) 235-5107
Mailing address
146 W DALE ST, SUITE 102, WATERLOO, IA 50703-1901
(319) 235-5050
(319) 235-5107

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
28288
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2077792
IA
05
4077792
IA
05
7077792
IA
01
P00079493
RAILROAD MEDICARE
IA
Enumeration date
12/28/2005
Last updated
02/06/2015
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