Provider Demographics
NPI:1760583884
Name:ORR, CAROL ANN (MD)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:ORR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:A
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:688 KINOOLE ST STE 120
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3811
Mailing Address - Country:US
Mailing Address - Phone:808-934-0481
Mailing Address - Fax:808-934-0640
Practice Address - Street 1:688 KINOOLE ST STE 120
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3811
Practice Address - Country:US
Practice Address - Phone:808-934-0481
Practice Address - Fax:808-934-0640
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-11881207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI523599-01Medicaid
HI0000238394OtherHMSA BILLING NUMBER
HIH55448Medicare PIN
HI0000238394OtherHMSA BILLING NUMBER