Provider Demographics
NPI:1922083443
Name:O'CONNOR, RORY VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:RORY
Middle Name:VINCENT
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:244 SMITH CHURCH RD
Mailing Address - Street 2:BLDG 5, MEDICAL PLAZA
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-4956
Mailing Address - Country:US
Mailing Address - Phone:252-535-1800
Mailing Address - Fax:252-535-3719
Practice Address - Street 1:244 SMITH CHURCH RD
Practice Address - Street 2:BLDG 5, MEDICAL PLAZA
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4956
Practice Address - Country:US
Practice Address - Phone:252-535-1800
Practice Address - Fax:252-535-3719
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2012-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2010-02092207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5916652Medicaid
NC2010-02092OtherLICENSE
NC2010-02092OtherLICENSE
NC2077112Medicare Oscar/Certification