Healthcare Provider Details

I. General information

NPI: 1528319357
Provider Name (Legal Business Name): WEST CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 09/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 WOLF RIVER BLVD SUITE 100
GERMANTOWN TN
38138-1754
US

IV. Provider business mailing address

100 N. HUMPHREYS BLVD.
MEMPHIS TN
38120-2146
US

V. Phone/Fax

Practice location:
  • Phone: 901-692-9600
  • Fax: 901-692-9606
Mailing address:
  • Phone: 901-683-0055
  • Fax: 901-685-2969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ERICH A MOUNCE
Title or Position: CEO
Credential:
Phone: 901-683-0055