Provider Demographics
NPI:1114083052
Name:RORICK, JAY THOMPSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:THOMPSON
Last Name:RORICK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:PPQA MEDICARE COMPLIANCE UNIT 6 WEST
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4918
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:888 BESTGATE ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3091
Practice Address - Country:US
Practice Address - Phone:410-571-7325
Practice Address - Fax:410-571-7301
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MDD33186152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E30519Medicare UPIN
558632M92Medicare ID - Type Unspecified