Healthcare Provider Details

I. General information

NPI: 1538369335
Provider Name (Legal Business Name): THOMAS H. LAMB, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PROFESSIONAL PL SUITE 110
CARROLLTON GA
30117-3874
US

IV. Provider business mailing address

100 PROFESSIONAL PL SUITE 110
CARROLLTON GA
30117-3874
US

V. Phone/Fax

Practice location:
  • Phone: 770-834-0818
  • Fax: 770-834-5098
Mailing address:
  • Phone: 770-834-0818
  • Fax: 770-834-5098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number18164
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License Number18164
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number18164
License Number StateGA

VIII. Authorized Official

Name: DR. THOMAS H LAMB
Title or Position: PRESIDENT
Credential: MD
Phone: 770-834-0818