Ortiz, Luis A.

Ortiz, Luis A. is an individual health care provider with primary practice located at 1120 15Th St , Augusta GA 30912-0004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Nephrology, which is considered as his primary health care specialty. Ortiz, Luis A. can be contacted via phone (706) 721-0177.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912-0004
Phone: (706) 721-0177
Fax: (706) 721-8017
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X 051260 Georgia

Profile Details

NPI number 1114026242
LBN Legal business name Ortiz, Luis A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Nov 30th, 2012 - about 13 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 1114026242 NPPES
South Carolina MEDICAID G51260
South Carolina MEDICAID 000947757A

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