Provider Demographics
NPI:1215991740
Name:WEST, DANIEL W (AU D)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:WEST
Suffix:
Gender:M
Credentials:AU D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BLYTHEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4828
Mailing Address - Country:US
Mailing Address - Phone:931-388-3646
Mailing Address - Fax:931-388-6184
Practice Address - Street 1:102 BLYTHEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4828
Practice Address - Country:US
Practice Address - Phone:931-388-3646
Practice Address - Fax:931-388-6184
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA1061231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3010421OtherBLUE CROSS BLUE SHIELD OF
TN3010421OtherBLUE CROSS BLUE SHIELD OF