Doctor Name: | MS. SANDRA JOAN ORR |
NPI Number: | 1174871792 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1871 |
Business Practice Address: | 2249 Vinson Hwy Se Milledgeville, GA - 310614807 |
Business Phone Number: | 4784451858 |
Business Fax Number: | 4784455190 |
Mailing Address: | 2249 Vinson Hwy Se, MILLEDGEVILLE |
State: | GA |
Postal Code: | 310614807 |
Phone Number: | 4784451858 |
Fax Number: | 4784455190 |
NPI Enumeration Date: | 08/29/2012 |
NPI Last Update Date: | 08/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1871 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |