Organization
WESLEY NEUROLOGY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES R LUCAS (ADMINISTRATOR)
(901) 725-8920
Entity
Organization
Contact information
Practice address
1211 UNION AVE, STE 400, MEMPHIS, TN 38104
(901) 725-8920
(901) 725-8936
Mailing address
PO BOX 1885, MEMPHIS, TN 38101-1885
(901) 725-8920
(901) 725-8936
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013571
—
MS
05
—
122543002
—
AR
05
—
3703205
—
TN
Enumeration date
05/16/2006
Last updated
09/26/2008
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