Provider Demographics
NPI:1245204882
Name:RIZOR, RANDY F (MD)
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:F
Last Name:RIZOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:790 CHURCH ST NE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7282
Mailing Address - Country:US
Mailing Address - Phone:770-419-9902
Mailing Address - Fax:770-419-7457
Practice Address - Street 1:5730 GLENRIDGE DR NE
Practice Address - Street 2:SUITE 100
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-6141
Practice Address - Country:US
Practice Address - Phone:404-816-3000
Practice Address - Fax:678-904-5797
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2019-09-17
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Provider Licenses
StateLicense IDTaxonomies
GA022875208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1710946322OtherGROUP NPI NUMBER
GA5078555OtherCIGNA
GA000270608EMedicaid
GA000270608EMedicaid
GA05BDDVRMedicare PIN
GA050043292Medicare PIN