Provider Demographics
NPI:1902627946
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:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:WHEALTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:502-419-0508
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:
Practice Address - Street 1:920 BARNES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3539
Practice Address - Country:US
Practice Address - Phone:859-544-1068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty