Healthcare Provider Details

I. General information

NPI: 1659375558
Provider Name (Legal Business Name): ROBERT C ORCHARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 N 13TH ST STE D
ARTESIA NM
88210-1167
US

IV. Provider business mailing address

702 N 13TH ST
ARTESIA NM
88210-1199
US

V. Phone/Fax

Practice location:
  • Phone: 575-736-8270
  • Fax:
Mailing address:
  • Phone: 575-748-3333
  • Fax: 505-843-2956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2000-84
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: