Individual
DR. CONRAD HARLAN EASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 BROADRICK DRIVE, SUITE 3, DALTON, GA 30720
(706) 226-6318
(706) 278-6031
Mailing address
1501 BROADRICK DRIVE, SUITE 3, DALTON, GA 30720
(706) 226-6318
(706) 278-6031
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
11323
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000084389A
—
GA
05
—
00084389A
—
GA
01
—
1326157488
NPI
GA
01
—
203503540
MEDICARE RAILROAD
GA
Enumeration date
08/30/2006
Last updated
02/28/2020
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