Individual
ERIK LILLEGRAVEN ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
240 W THOMAS RD STE 400, PHOENIX, AZ 85013-4407
(602) 406-6262
(602) 406-6260
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
42039
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
448447
—
AZ
Enumeration date
06/29/2007
Last updated
05/02/2023
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