Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 22651 | CO |
NPI | 1144232679 |
---|---|
Provider Name | William F Orr JR. |
First Address | Albuquerque, NM 87113 |
Second Address | Albuquerque, NM 87113-2476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 25/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
EO6418 | (02) | CO |