Provider Demographics
NPI:1811150550
Name:ROBERT L ORME, MD PC
Entity type:Organization
Organization Name:ROBERT L ORME, MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ORME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-572-8043
Mailing Address - Street 1:11760 SOUTH 700 EAST
Mailing Address - Street 2:#210
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:80420-6604
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT180576-1205207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT529668077009Medicaid
UT529668077009Medicaid
UTE33791Medicare UPIN