Provider Demographics
NPI:1487112843
Name:ATLAS PAIN AND SPINE PLLC
Entity type:Organization
Organization Name:ATLAS PAIN AND SPINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEALTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:606-280-7875
Mailing Address - Street 1:1498 W CUMBERLAND GAP PKWY
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-5902
Mailing Address - Country:US
Mailing Address - Phone:606-280-7875
Mailing Address - Fax:833-974-2501
Practice Address - Street 1:1498 W CUMBERLAND GAP PKWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-5902
Practice Address - Country:US
Practice Address - Phone:606-280-7578
Practice Address - Fax:833-974-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty