Provider Demographics
NPI:1558507442
Name:ORTON, DONALD CHARLES (IDC)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:CHARLES
Last Name:ORTON
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NAVAL STATION NORFOLK
Mailing Address - Street 2:BLDG CEP 171
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23511
Mailing Address - Country:US
Mailing Address - Phone:757-444-0126
Mailing Address - Fax:
Practice Address - Street 1:8857 1ST ST BLDG CEP 86 SUITE 400
Practice Address - Street 2:PCD COMMANDER PRECOMDET NEW YORK (LPD 21) C/O DDG CLASS
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23511-3719
Practice Address - Country:US
Practice Address - Phone:757-444-0126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman