Provider Demographics
NPI:1487639373
Name:ORGLER, RAYMOND J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:J
Last Name:ORGLER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 PEGRAM DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6319
Mailing Address - Country:US
Mailing Address - Phone:662-844-5344
Mailing Address - Fax:662-844-5363
Practice Address - Street 1:440 PEGRAM DR
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6319
Practice Address - Country:US
Practice Address - Phone:662-844-5344
Practice Address - Fax:662-844-5363
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17566208600000X, 2086S0129X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00125698Medicaid
MS020000436Medicare ID - Type Unspecified
MSH58263Medicare UPIN