Provider Demographics
NPI:1639956246
Name:DR THOMAS WHEALTON PSC
Entity Type:Organization
Organization Name:DR THOMAS WHEALTON PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-971-4344
Mailing Address - Street 1:1601 HIGHWAY 121 BYP N STE B
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-8759
Mailing Address - Country:US
Mailing Address - Phone:270-971-4344
Mailing Address - Fax:
Practice Address - Street 1:1601 HIGHWAY 121 BYP N STE B
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-8759
Practice Address - Country:US
Practice Address - Phone:270-971-4344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty