Provider Demographics
NPI:1215932041
Name:CONFORTI, ARNOLD MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:MICHAEL
Last Name:CONFORTI
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 1:800 FIRST STREET
Mailing Address - Street 2:SUITE 240
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201
Mailing Address - Country:US
Mailing Address - Phone:478-633-6900
Mailing Address - Fax:478-633-4295
Practice Address - Street 1:800 1ST ST STE 240
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8300
Practice Address - Country:US
Practice Address - Phone:478-633-6900
Practice Address - Fax:478-633-4295
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0518722086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00972859AMedicaid
GAF85379Medicare UPIN
GA00972859AMedicaid