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General NPI Number Information
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NPI Number | 1477791143
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Entity Type | Individual
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Provider Name | AILEE MARK LAHAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 1342 OLD WEISGARBER RD
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City | KNOXVILLE
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State | TN
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Zip | 37909-1291
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Country | US
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Telephone | 865-588-0811
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Fax |
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Provider Business Mailing Address
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Address Line | 9050 EXECUTIVE PARK DR STE 202A
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City | KNOXVILLE
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State | TN
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Zip | 37923-4670
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Country | US
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Telephone | 865-588-0811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD17029
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 55708
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License Number State | TN
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