Willis-Knighton Medical Center, INC.
Obstetrics & Gynecology in Shreveport, LA. Organization (NPI-2).
NPI number1790057735
StatusActive
Last updated in NPPESFeb 7, 2012
Details
- NPI
- 1790057735
- Entity type
- Organization (NPI-2)
- Legal business name
- Willis-Knighton Medical Center, INC.
- Organization subpart
- Yes
- Enumeration date
- Feb 7, 2012
- Last updated
- Feb 7, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | – | – | Yes |
Other names
- A Wk Clinic For Women - South (Doing Business As)
Practice location
2508 Bert Kouns LoopSuite 105
Shreveport, LA 71118-3133
Phone 318-212-8780 · Fax 318-212-6752
Mailing address
2508 Bert Kouns LoopSuite 105
Shreveport, LA 71118-3133
Phone 318-212-8780 · Fax 318-212-6752
Authorized official
Greg J Gavin
Network Administrator
3182124232
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