Healthcare Provider Details

I. General information

NPI: 1275428336
Provider Name (Legal Business Name): JOSEPH GRIFFIN ORR CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: J. GRIFFIN ORR CRNA

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 RIVER OAKS DR
FLOWOOD MS
39232-9553
US

IV. Provider business mailing address

11 BEAUVOIR PL
MADISON MS
39110-8047
US

V. Phone/Fax

Practice location:
  • Phone: 601-932-1030
  • Fax:
Mailing address:
  • Phone: 601-559-6075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number155115
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: