Organization
THE WEST CLINIC, PLLC
Active
Other names
West Clinic, PC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN M GRAVES (CEO)
(901) 683-0055
Entity
Organization
Contact information
Practice address
1936 W POPLAR AVE, COLLIERVILLE, TN 38017-0605
(901) 853-6012
(901) 854-7630
Mailing address
7714 POPLAR AVE., SUITE 200, ATTN: CREDENTIALING, GERMANTOWN, TN 38138-3941
(901) 683-0055
(901) 922-6722
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3704066
—
TN
Enumeration date
10/24/2016
Last updated
12/14/2021
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