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General NPI Number Information
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NPI Number | 1639934391
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Entity Type | Individual
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Provider Name | DWAYNE LAH'KEIM THOMAS II MD
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Gender | Male
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Dates
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Enumeration Date | 02/20/2024
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 80 JESSE HILL JR DR SE
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City | ATLANTA
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State | GA
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Zip | 30303-3050
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Country | US
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Telephone | 404-616-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 720 WESTVIEW DR SW
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City | ATLANTA
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State | GA
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Zip | 30310-1458
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Country | US
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Telephone |
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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 | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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