MEDICARE: DR. DAVID E ORSON OD

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	152W00000X	Optometrist	TO3192	MO
2	152W00000X	Optometrist	1439	KS

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	:	1043290562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E ORSON OD

Provider Business Mailing Address
First Line	:	4247 SW FLINTROCK DR
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64082-4840
Country	:	US
Telephone Number	:	816-537-6278
Fax Number	:

Provider Business Practice Location Address
First Line	:	3536 SW MARKET ST
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64082-2327
Country	:	US
Telephone Number	:	816-537-0011
Fax Number	:	816-537-0402

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	11/05/2010

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Directions to “ DR. DAVID E ORSON OD” Practice Location

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