Provider Demographics
NPI:1346249265
Name:FLORY, RAND (MD)
Entity Type:Individual
Prefix:
First Name:RAND
Middle Name:
Last Name:FLORY
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 1:721 SHERIDAN AVE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-3423
Mailing Address - Country:US
Mailing Address - Phone:307-527-7811
Mailing Address - Fax:307-527-7396
Practice Address - Street 1:721 SHERIDAN AVE
Practice Address - Street 2:SUITE #100
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-3423
Practice Address - Country:US
Practice Address - Phone:307-527-7811
Practice Address - Fax:307-527-7396
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3361A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY312169OtherBCBS
WYW4110095Medicare ID - Type Unspecified
WYA73039Medicare UPIN