Organization
WEST CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE M COPLON (CEO)
(901) 683-0055
Entity
Organization
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(901) 683-0055
(901) 322-2970
Mailing address
100 N HUMPHREYS BLVD, MEMPHIS, TN 38120-2146
(901) 683-0055
(901) 322-2970
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013755
—
MS
01
—
8P003
AR BCBS
AR
Enumeration date
01/02/2008
Last updated
04/20/2008
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