Provider Demographics
NPI:1992729123
Name:ORREN, G WILLIAM (OD)
Entity type:Individual
Prefix:
First Name:G
Middle Name:WILLIAM
Last Name:ORREN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 HARDEES DR
Mailing Address - Street 2:
Mailing Address - City:MIFFLINBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17844-7062
Mailing Address - Country:US
Mailing Address - Phone:570-966-5582
Mailing Address - Fax:
Practice Address - Street 1:90 QUEEN ST
Practice Address - Street 2:
Practice Address - City:NORTHUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17857-1948
Practice Address - Country:US
Practice Address - Phone:570-473-1715
Practice Address - Fax:570-473-8551
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000763152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
02449000OtherCAPITAL BLUE CROSS
038367LGBOtherLEWISBURG MEDICARE UPIN
410021857OtherRAILROAD
038367LGBOtherLEWISBURG MEDICARE UPIN
410021857OtherRAILROAD
38367E3FMedicare PIN
02449000OtherCAPITAL BLUE CROSS