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Organization
WK SHREVEPORT INTERNAL MEDICINE
Active
Organization
WK SHREVEPORT INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE WARD (SENIOR VP FINANCE)
(318) 716-4939
Entity
Organization
Contact information
Practice address
1449 E BERT KOUNS INDUSTRIAL LOOP STE 100, SHREVEPORT, LA 71105-5680
(318) 629-0220
(318) 629-0230
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 716-4939
(318) 716-4854
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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