Provider Demographics
NPI:1194823039
Name:ROCKINGHAM ORTHOPAEDIC ASSOCIATES PA
Entity Type:Organization
Organization Name:ROCKINGHAM ORTHOPAEDIC ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:KEELING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-342-6116
Mailing Address - Street 1:601 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-5019
Mailing Address - Country:US
Mailing Address - Phone:336-342-6116
Mailing Address - Fax:336-342-6451
Practice Address - Street 1:601 S MAIN ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5019
Practice Address - Country:US
Practice Address - Phone:336-342-6116
Practice Address - Fax:336-342-6451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC40176207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0277920002Medicare NSC