Individual
ROBERT MICHAEL ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1118 ROSS CLARK CIR STE 303, DOTHAN, AL 36301-3002
(334) 794-3192
(877) 553-0033
Mailing address
1118 ROSS CLARK CIR STE 303, DOTHAN, AL 36301-3034
(334) 794-3192
(877) 553-0033
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-095354
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210987
—
AL
01
—
515-03239
BCBSAL
AL
Enumeration date
02/05/2007
Last updated
03/13/2019
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