MEDICARE: DR. LOUIS L. ORR IV PSYD

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	103T00000X	Psychologist	PY 9217	FL

General Provider Information

NPI Number	:	1679963938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS L. ORR IV PSYD

Provider Business Mailing Address
First Line	:	2804 W MARC KNIGHTON CT
Second Line	:	SUITE A
City	:	LECANTO
State	:	FL
Zip	:	34461-8334
Country	:	US
Telephone Number	:	352-746-8067
Fax Number	:	352-746-8069

Provider Business Practice Location Address
First Line	:	2804 W MARC KNIGHTON CT
Second Line	:	SUITE A
City	:	LECANTO
State	:	FL
Zip	:	34461-8334
Country	:	US
Telephone Number	:	352-746-8067
Fax Number	:	352-746-8069

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

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	01/26/2015

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