| Organization Name: | WEST WILSON FAMILY PRACTICE CENTER, P.C. |
| NPI Number: | 1598779837 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BERNARD PARE (PRESIDENT) |
| Mailing Address: | 3500 N Mount Juliet Rd Mt Juliet |
| State: | TN US |
| Postal Code: | 371223078 |
| Phone Number: | 6157585672 |
| Fax Number: | 6157585609 |
| NPI Enumeration Date: | 07/29/2006 |
| NPI Last Update Date: | 07/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |