Provider Demographics
NPI:1174826572
Name:WESTGATE HEALTH SERVICES, PLLC
Entity Type:Organization
Organization Name:WESTGATE HEALTH SERVICES, PLLC
Other - Org Name:WESTGATE HEALTH SERVICES - PRESLEY BRANCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCT MGR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-344-7860
Mailing Address - Street 1:4466 ELVIS PRESLEY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-7100
Mailing Address - Country:US
Mailing Address - Phone:901-344-7860
Mailing Address - Fax:901-396-9087
Practice Address - Street 1:4466 ELVIS PRESLEY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-7100
Practice Address - Country:US
Practice Address - Phone:901-344-7860
Practice Address - Fax:901-396-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty