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General NPI Number Information
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NPI Number | 1477270312
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Entity Type | Organization
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Legal Business Name | THE WEST CLINIC, PLLC
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 6005 PARK AVE STE 700
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City | MEMPHIS
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State | TN
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Zip | 38119-5217
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Country | US
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Telephone | 901-527-3391
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Fax | 901-578-3969
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Provider Business Mailing Address
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Address Line | 7714 POPLAR AVE STE 200
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City | GERMANTOWN
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State | TN
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Zip | 38138-3941
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Country | US
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Telephone | 901-683-0055
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOHN MITCHELL GRAVES
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Credential |
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Telephone | 901-683-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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