Provider Demographics
NPI:1114925302
Name:ORME, LAURIE ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANNE
Last Name:ORME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-8196
Mailing Address - Country:US
Mailing Address - Phone:405-715-2000
Mailing Address - Fax:405-715-2010
Practice Address - Street 1:301 E WATERLOO RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-8196
Practice Address - Country:US
Practice Address - Phone:405-715-2000
Practice Address - Fax:405-715-2010
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21203207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100108270AMedicaid
L012101171Medicare PIN
H56898Medicare UPIN