Provider Demographics
NPI:1043293939
Name:ORR, WILLIAM CHRISTOPHER (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHRISTOPHER
Last Name:ORR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 JOHNNIE DODDS BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6152
Mailing Address - Country:US
Mailing Address - Phone:843-884-4343
Mailing Address - Fax:843-884-4616
Practice Address - Street 1:1055 JOHNNIE DODDS BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6152
Practice Address - Country:US
Practice Address - Phone:843-884-4343
Practice Address - Fax:843-884-4616
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC725152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDD0725Medicaid
SC410035219Medicare PIN
T24993Medicare UPIN
SCDD0725Medicaid