Provider Demographics
NPI:1801086731
Name:JERRY M. ORREN MD APC
Entity type:Organization
Organization Name:JERRY M. ORREN MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ORREN
Authorized Official - Suffix:
Authorized Official - Credentials:M D,
Authorized Official - Phone:907-563-3601
Mailing Address - Street 1:1120 HUFFMAN RD
Mailing Address - Street 2:PMB 205, SUITE 23
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3516
Mailing Address - Country:US
Mailing Address - Phone:907-563-3601
Mailing Address - Fax:907-563-7601
Practice Address - Street 1:2751 DEBARR RD
Practice Address - Street 2:SUITE 360
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2953
Practice Address - Country:US
Practice Address - Phone:907-563-3601
Practice Address - Fax:907-563-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1290207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty