Provider Demographics
NPI:1740013739
Name:DR WHALEY PAIN MANAGEMENT CLINIC
Entity type:Organization
Organization Name:DR WHALEY PAIN MANAGEMENT CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHALEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-554-6005
Mailing Address - Street 1:PO BOX 55990
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72215-5990
Mailing Address - Country:US
Mailing Address - Phone:501-227-0700
Mailing Address - Fax:501-227-0744
Practice Address - Street 1:413 E MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-3269
Practice Address - Country:US
Practice Address - Phone:501-227-0700
Practice Address - Fax:501-227-0744
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR WHALEY PAIN MANAGEMENT CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty