Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 2463A | WY |
NPI | 1114916087 |
---|---|
Provider Name | Ronald E Orbin |
First Address | Powell, WY 82435-2232 |
Second Address | Powell, WY 82435-2260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012181 | MT MEDICAID (01) | MT |
305356 | BLUE CROSS BLUE SHIELD (01) | WY |
E61155 | (02) | WY |