Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 17566 | MS |
Y | 208600000X | Surgeon | 17566 | MS |
N | 2086S0127X | Trauma Surgeon | 17566 | MS |
N | 2086S0129X | Vascular Surgeon | 17566 | MS |
NPI | 1487639373 |
---|---|
Provider Name | Dr. Raymond J Orgler JR. |
First Address | Tupelo, MS 38801-6319 |
Second Address | Tupelo, MS 38801-6319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 21/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00125698 | (05) | MS |
H58263 | (02) | MS |