Provider Demographics
NPI:1073801965
Name:CONNOR, RANDI SHAE (MD)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:SHAE
Last Name:CONNOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:102 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-1503
Mailing Address - Country:US
Mailing Address - Phone:423-266-3636
Mailing Address - Fax:423-266-3633
Practice Address - Street 1:102 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:423-266-3636
Practice Address - Fax:423-266-3633
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2018-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN57517207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology