Provider Demographics
NPI:1740411735
Name:ATNIP CLINICAL OFFICES, P.C.
Entity Type:Organization
Organization Name:ATNIP CLINICAL OFFICES, P.C.
Other - Org Name:TENNESSEE SPINE JOINT AND PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-526-5311
Mailing Address - Street 1:126 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3918
Mailing Address - Country:US
Mailing Address - Phone:931-526-5311
Mailing Address - Fax:
Practice Address - Street 1:126 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3918
Practice Address - Country:US
Practice Address - Phone:931-526-5311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-07
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000000116111N00000X
TN0000036764208D00000X
TNAPN0000012286363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
350101623OtherRAILROAD MEDICARE
36706911Medicare PIN
T74742Medicare UPIN