Individual
RANDALA R LAKKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3023 HAMAKER CT STE 600, FAIRFAX, VA 22031-2241
(703) 876-2788
(703) 839-8763
Mailing address
3023 HAMAKER CT STE 600, FAIRFAX, VA 22031-2241
(703) 876-2788
(703) 839-8763
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
0101238274
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277144600
—
FL
Enumeration date
10/06/2006
Last updated
11/27/2023
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