Healthcare Provider Details

I. General information

NPI: 1144370362
Provider Name (Legal Business Name): WEST CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 HIGHWAY 51 S STE 208
COVINGTON TN
38019-3635
US

IV. Provider business mailing address

PO BOX 240728
MEMPHIS TN
38124-0728
US

V. Phone/Fax

Practice location:
  • Phone: 901-818-0300
  • Fax: 901-818-0458
Mailing address:
  • Phone: 901-683-0055
  • Fax: 901-322-9097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE COPLON
Title or Position: CEO
Credential:
Phone: 901-683-0055