1609887124 NPI number — DR. ALEX N ORSINI MD

Table of content: DR. ALEX N ORSINI MD (NPI 1609887124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609887124 NPI number — DR. ALEX N ORSINI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORSINI
Provider First Name:
ALEX
Provider Middle Name:
N
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609887124
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9501 LILE DR
Provider Second Line Business Mailing Address:
STE 600
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72205-6225
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-227-7596
Provider Business Mailing Address Fax Number:
501-227-7787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9501 LILE DR STE 600
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72205-6231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-227-7596
Provider Business Practice Location Address Fax Number:
501-978-1919
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  E3240 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207UN0901X , with the licence number: E3240 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CC6745 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 5M151 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 146872001 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 89Y281 . This is a "MALP INS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: CN1884 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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