Provider Demographics
NPI:1164775672
Name:THE ATLAS GROUP, INC
Entity Type:Organization
Organization Name:THE ATLAS GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:P
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-887-2303
Mailing Address - Street 1:104 COLONY PARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2772
Mailing Address - Country:US
Mailing Address - Phone:770-887-2303
Mailing Address - Fax:770-889-5556
Practice Address - Street 1:104 COLONY PARK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2792
Practice Address - Country:US
Practice Address - Phone:770-887-2303
Practice Address - Fax:770-889-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X, 225100000X
GA44237207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU57855Medicare UPIN
GA35ZCDCFMedicare PIN