Provider Demographics
NPI:1598846297
Name:CONATSER, JOHN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:CONATSER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:5780 PEACHTREE DUNWOODY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1513
Mailing Address - Country:US
Mailing Address - Phone:404-303-8035
Mailing Address - Fax:404-303-1325
Practice Address - Street 1:5780 PEACHTREE DUNWOODY RD STE 295
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1544
Practice Address - Country:US
Practice Address - Phone:042-553-6334
Practice Address - Fax:404-255-7599
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL2-8934207V00000X
GA80795207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA300034164AMedicaid
GAGRP3569OtherMEDICARE OPT-OUT