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Organization
TOM RODSUWAN MD AND WILLIS KNIGHTON MEDICAL CENTER
Active
Organization
TOM RODSUWAN MD AND WILLIS KNIGHTON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-8780
Entity
Organization
Contact information
Practice address
2300 HOSPITAL DR, SUITE 200, BOSSIER CITY, LA 71111-2394
(318) 212-7830
(318) 212-7835
Mailing address
2300 HOSPITAL DR, SUITE 200, BOSSIER CITY, LA 71111-2394
(318) 212-7830
(318) 212-7835
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/12/2006
Last updated
08/22/2020
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