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NPI Code Detail

MEDICARE: THE WEST CLINIC, PLLC

MEDICARE: THE WEST CLINIC, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1508644774
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE WEST CLINIC, PLLC
Provider Business Mailing Address
First Line : 7714 POPLAR AVE STE 200
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-3941
Country : US
Telephone Number : 901-683-0055
Fax Number : 901-685-2969
Provider Business Practice Location Address
First Line : 1727 KIRBY PKWY STE 100
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-4335
Country : US
Telephone Number : 901-685-5520
Fax Number : 901-685-0782
Authorized Official
Title or Position : CEO
Name : JOHN MITCHELL GRAVES
Credential :
Telephone Number : 901-683-0055
Provider Enumeration Date : 09/19/2023
Last Update Date : 09/19/2023

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Directions to “THE WEST CLINIC, PLLC ” Practice Location

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