Healthcare Provider Details

I. General information

NPI: 1811956550
Provider Name (Legal Business Name): BRANDON S RORIE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ARTHUR DR
THOMASVILLE NC
27360-6275
US

IV. Provider business mailing address

200 ARTHUR DR
THOMASVILLE NC
27360-6275
US

V. Phone/Fax

Practice location:
  • Phone: 336-475-2348
  • Fax: 366-475-2100
Mailing address:
  • Phone: 336-475-2348
  • Fax: 366-475-2100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number101996
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: