Healthcare Provider Details

I. General information

NPI: 1992729123
Provider Name (Legal Business Name): G WILLIAM ORREN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 QUEEN ST
NORTHUMBERLAND PA
17857-1948
US

IV. Provider business mailing address

88 HARDEES DR
MIFFLINBURG PA
17844-7062
US

V. Phone/Fax

Practice location:
  • Phone: 570-473-1715
  • Fax: 570-473-8551
Mailing address:
  • Phone: 570-966-5582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000763
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: