MEDICARE: DR. JENNIFER WELLS ORR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	9701092	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033191721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER WELLS ORR M.D.

Provider Business Mailing Address
First Line	:	4251 ARENDELL ST
Second Line	:	STE C
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2869
Country	:	US
Telephone Number	:	252-222-0660
Fax Number	:	252-222-0663

Provider Business Practice Location Address
First Line	:	4251 ARENDELL ST
Second Line	:	STE C
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2869
Country	:	US
Telephone Number	:	252-222-0660
Fax Number	:	252-222-0663

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	12/21/2016

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