Provider Demographics
NPI:1982814141
Name:ATLANTA OCCUPATIONAL MEDICINE
Entity Type:Organization
Organization Name:ATLANTA OCCUPATIONAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-256-1920
Mailing Address - Street 1:993 JOHNSON FERRY RD NE # F
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1620
Mailing Address - Country:US
Mailing Address - Phone:404-256-1920
Mailing Address - Fax:404-256-0192
Practice Address - Street 1:993 JOHNSON FERRY RD NE # F
Practice Address - Street 2:SUITE 210
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-256-1920
Practice Address - Fax:404-256-0192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017903261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD42393Medicare UPIN