Provider Demographics
NPI:1043675036
Name:SLEEP STUDY CLINICS OF WEST TENNESSEE, LLC
Entity Type:Organization
Organization Name:SLEEP STUDY CLINICS OF WEST TENNESSEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-461-8009
Mailing Address - Street 1:7730 WOLF RIVER BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1737
Mailing Address - Country:US
Mailing Address - Phone:901-405-1023
Mailing Address - Fax:
Practice Address - Street 1:7730 WOLF RIVER BLVD STE 106
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1737
Practice Address - Country:US
Practice Address - Phone:901-405-1023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-18
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3791004OtherPTAN