Provider Demographics
NPI:1578524062
Name:ORR, MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:ORR
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-8868
Mailing Address - Country:US
Mailing Address - Phone:740-522-5483
Mailing Address - Fax:740-522-5481
Practice Address - Street 1:1665 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-8868
Practice Address - Country:US
Practice Address - Phone:740-522-5483
Practice Address - Fax:740-522-5481
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-03245111N00000X
OH3245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2609609Medicaid
OHOR4066993Medicare ID - Type Unspecified
OHU88548Medicare UPIN
OHOR4066994Medicare ID - Type Unspecified