Healthcare Provider Details
I. General information
NPI: 1932280682
Provider Name (Legal Business Name): THOMAS W WEHMANN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/18/2006
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1061 PARK DR
GREENSBORO GA
30642-3465
US
IV. Provider business mailing address
1109 MEDICAL CENTER DR BLDG 1A
AUGUSTA GA
30909-6633
US
V. Phone/Fax
- Phone: 866-328-8346
- Fax:
- Phone: 706-854-3333
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 061183 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 061183 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: