Ricky G Davidson MD And Willis Knighton Medical Center
Family Medicine in Bossier City, LA. Organization (NPI-2).
NPI number1619919982
StatusActive
Last updated in NPPESDec 13, 2007
Details
- NPI
- 1619919982
- Entity type
- Organization (NPI-2)
- Legal business name
- Ricky G Davidson MD And Willis Knighton Medical Center
- Organization subpart
- No
- Enumeration date
- Jun 12, 2006
- Last updated
- Dec 13, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
2300 Hospital DrSuite 200
Bossier City, LA 71111-2394
Phone 318-212-7830 · Fax 318-212-7835
Mailing address
2300 Hospital DrSuite 200
Bossier City, LA 71111-2394
Phone 318-212-7830 · Fax 318-212-7835
Authorized official
Greg J. Gavin
Network Administrator
3182128780
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All 56 Family Medicine Physician providers in Bossier City · All 1,861 providers in Bossier City
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