Provider Demographics
NPI:1811956550
Name:RORIE, BRANDON S (PA)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:S
Last Name:RORIE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-6275
Mailing Address - Country:US
Mailing Address - Phone:336-475-2348
Mailing Address - Fax:366-475-2100
Practice Address - Street 1:200 ARTHUR DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-6275
Practice Address - Country:US
Practice Address - Phone:336-475-2348
Practice Address - Fax:366-475-2100
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101996363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00601909OtherRAILROAD MEDICARE
NC8101458Medicaid
NCP00601909OtherRAILROAD MEDICARE
S53371Medicare UPIN
NCP00601909OtherRAILROAD MEDICARE