Provider Demographics
NPI:1609820190
Name:ORWIG, DAVID MICHAEL (O D)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:ORWIG
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-0509
Mailing Address - Country:US
Mailing Address - Phone:731-635-0991
Mailing Address - Fax:731-635-7372
Practice Address - Street 1:2439 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343-1753
Practice Address - Country:US
Practice Address - Phone:731-784-1186
Practice Address - Fax:731-784-0601
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD1496152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN32098OtherTLC MEMPHIS MANAGED CARE
9491076OtherCIGNA HEALTHCARE
10023282OtherVESTICA HEALTH PLAN
TN3946215Medicaid
TN4105805OtherBLUE CROSS BLUE SHIELD
TN3946215Medicare PIN
TN32098OtherTLC MEMPHIS MANAGED CARE
TN4105805OtherBLUE CROSS BLUE SHIELD