Provider Demographics
NPI:1184716813
Name:CAIN, THOMAS DOUGLAS (DPM)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DOUGLAS
Last Name:CAIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 N DECATUR RD STE 295
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5936
Mailing Address - Country:US
Mailing Address - Phone:404-778-0204
Mailing Address - Fax:404-544-1479
Practice Address - Street 1:2801 N DECATUR RD STE 295
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5936
Practice Address - Country:US
Practice Address - Phone:404-778-0204
Practice Address - Fax:404-544-1479
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000509213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000317017AMedicaid
CJ8031OtherMEDICARE RAILROAD
U02636Medicare UPIN
GA000317017AMedicaid