Healthcare Provider Details

I. General information

NPI: 1043611734
Provider Name (Legal Business Name): KIMBERLY G ORR OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2014
Last Update Date: 04/08/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 B NEW GARDENS RD
GREENSBORO NC
27410-2798
US

IV. Provider business mailing address

6208 BUCKHORN RD
GREENSBORO NC
27410-3124
US

V. Phone/Fax

Practice location:
  • Phone: 336-553-0800
  • Fax: 336-553-0353
Mailing address:
  • Phone: 919-414-6938
  • Fax: 336-434-6680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberNC2391
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: