Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 5139 | AL |
N | 204E00000X | Oral & Maxillofacial Surgeon | 5139 | AL |
NPI | 1215062211 |
---|---|
Provider Name | Frank Edward Orr |
First Address | Gadsden, AL 35903-1107 |
Second Address | Gadsden, AL 35903-1107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 17/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051515310 | (05) | AL |
515-15310 | BLUE CROSS BLUE SHIELD (01) | AL |
U95359 | (02) | AL |