Provider Demographics
NPI:1962845503
Name:ATLAS HEALTH, PLLC
Entity Type:Organization
Organization Name:ATLAS HEALTH, PLLC
Other - Org Name:ATLAS MEN'S HEALTH, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PA-C
Authorized Official - Prefix:MR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-509-2738
Mailing Address - Street 1:14 N MCLEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2645
Mailing Address - Country:US
Mailing Address - Phone:901-509-2738
Mailing Address - Fax:901-509-2740
Practice Address - Street 1:14 N MCLEAN BLVD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2645
Practice Address - Country:US
Practice Address - Phone:901-509-2738
Practice Address - Fax:901-509-2740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-13
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty