Provider Demographics
NPI:1174635403
Name:ORME, ROBERT LYNN (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LYNN
Last Name:ORME
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11760 SOUTH 700 EAST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-6604
Mailing Address - Country:US
Mailing Address - Phone:801-572-8043
Mailing Address - Fax:801-576-4285
Practice Address - Street 1:11760 SOUTH 700 EAST
Practice Address - Street 2:SUITE 210
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-6604
Practice Address - Country:US
Practice Address - Phone:801-572-8043
Practice Address - Fax:801-576-4285
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT1805761205207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000004695Medicaid
UT$$$$$$$$$009Medicaid
UT000004695Medicaid
UT$$$$$$$$$009Medicaid