Healthcare Provider Details

I. General information

NPI: 1740248046
Provider Name (Legal Business Name): GUY R ORANGIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1542 TULANE AVE 747
NEW ORLEANS LA
70112-2865
US

IV. Provider business mailing address

1542 TULANE AVE 747
NEW ORLEANS LA
70112-2865
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-4750
  • Fax: 504-568-4633
Mailing address:
  • Phone: 504-568-4750
  • Fax: 504-568-4633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number205706
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: