Provider Demographics
NPI:1083774764
Name:CONFER, RAND A (MD)
Entity Type:Individual
Prefix:
First Name:RAND
Middle Name:A
Last Name:CONFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932203
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-2203
Mailing Address - Country:US
Mailing Address - Phone:706-256-3450
Mailing Address - Fax:706-256-3454
Practice Address - Street 1:1014 AUGUSTA RD
Practice Address - Street 2:SUITE 1
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-8498
Practice Address - Country:US
Practice Address - Phone:706-595-4674
Practice Address - Fax:706-595-0088
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA41535174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I309184Medicare PIN
GA47BBBGZMedicare PIN