Organization
THE CHILDREN'S CLINIC OF WEST TENNESSEE P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID LESLIE SELF JR. M.D. (PARTNER)
(731) 423-1500
Entity
Organization
Contact information
Practice address
264 COATSLAND DR, JACKSON, TN 38301-3948
(731) 423-1500
(731) 423-0342
Mailing address
264 COATSLAND DR, JACKSON, TN 38301-3948
(731) 423-1500
(731) 423-0342
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
06/06/2008
Last updated
06/06/2008
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