Provider Demographics
NPI:1407412471
Name:VETHANAYAGAM, KAJENE THASAN (OD)
Entity type:Individual
Prefix:DR
First Name:KAJENE
Middle Name:THASAN
Last Name:VETHANAYAGAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KAJENE
Other - Middle Name:
Other - Last Name:MURUGATHASAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:THOMAS EYE CENTER
Mailing Address - Street 2:1077 BAXTER STREET, SUITE 100
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3767
Mailing Address - Country:US
Mailing Address - Phone:706-549-7757
Mailing Address - Fax:706-549-4186
Practice Address - Street 1:THOMAS EYE CENTER
Practice Address - Street 2:1077 BAXTER STREET, SUITE 100
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3767
Practice Address - Country:US
Practice Address - Phone:706-549-7757
Practice Address - Fax:706-549-4186
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003162152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist