=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548642333
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHRISTOPHER W ORENDORFF MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/29/2015
-----------------------------------------------------
Last Update Date | 07/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1109 E CHEROKEE AVE
-----------------------------------------------------
City | SALLISAW
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74955-5035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-790-3309
-----------------------------------------------------
Fax | 918-775-0587
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1019
-----------------------------------------------------
City | SALLISAW
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74955-1019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-790-3309
-----------------------------------------------------
Fax | 918-775-0587
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHRISTOPHER WILLIAM ORENDORFF
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 918-790-3309
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------