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General NPI Number Information
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NPI Number | 1598219784
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Entity Type | Individual
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Provider Name | THOMAS KOEPKE OD
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Gender | Male
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Dates
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Enumeration Date | 08/05/2016
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 2458 JETT FERRY RD STE 230
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City | DUNWOODY
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State | GA
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Zip | 30338-3060
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Country | US
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Telephone | 404-678-4874
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Fax | 404-678-4804
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Provider Business Mailing Address
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Address Line | 2458 JETT FERRY RD STE 230
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City | DUNWOODY
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State | GA
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Zip | 30338-3060
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Country | US
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Telephone | 404-678-4874
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Fax | 404-678-4804
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003141
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License Number State | GA
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