MEDICARE: DR. PAUL DOUGLAS ORANGE 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	207Q00000X	Family Medicine Physician	MD039208L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00464067	OTHER	PA	RAILROAD MEDICARE

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	:	1275522914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL DOUGLAS ORANGE M.D.

Provider Business Mailing Address
First Line	:	4225 LINCOLN WAY E
Second Line	:	P.O. BOX 608
City	:	FAYETTEVILLE
State	:	PA
Zip	:	17222-1051
Country	:	US
Telephone Number	:	717-352-3616
Fax Number	:	717-352-9013

Provider Business Practice Location Address
First Line	:	4225 LINCOLN WAY E
Second Line	:
City	:	FAYETTEVILLE
State	:	PA
Zip	:	17222-1051
Country	:	US
Telephone Number	:	717-352-3616
Fax Number	:	717-352-9013

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

Provider Enumeration Date	:	10/16/2005
Last Update Date	:	12/30/2009

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