Provider Demographics
NPI:1932340924
Name:DAVID A WEST
Entity Type:Organization
Organization Name:DAVID A WEST
Other - Org Name:WEST SPORTS MEDICINE & ORTHO LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:615-781-1001
Mailing Address - Street 1:5435 EDMONDSON PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5806
Mailing Address - Country:US
Mailing Address - Phone:615-781-1001
Mailing Address - Fax:615-781-1002
Practice Address - Street 1:5435 EDMONDSON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5808
Practice Address - Country:US
Practice Address - Phone:615-781-1001
Practice Address - Fax:615-781-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO1318207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN33079072OtherMEDICARE PTAN
TN1513684Medicaid
TN33079072OtherMEDICARE PTAN