Ortenzi, Lisa

Ortenzi, Lisa is an individual health care provider with primary practice located at 880 Crestmark Dr Suite 200, Lithia Springs GA 30122-2646. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Ortenzi, Lisa can be contacted via phone (770) 941-8662.

Contact Information

Primary practice address
880 Crestmark Dr Suite 200 Lithia Springs GA 30122-2646
Phone: (770) 941-8662
Fax: (770) 739-6006
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 023395 Georgia

Profile Details

NPI number 1538153101
LBN Legal business name Ortenzi, Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2005
Last updated Aug 4th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538153101 NPPES
Georgia Other 58-1397572 FEDERAL TAX ID#
Georgia MEDICAID 00405358A FEDERAL TAX ID#

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