# WK PIERREMONT ENDOCRINE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265840268
- **Authorized official:** GREG J GAVIN (NETWORK ADMINISTRATOR)
- **Authorized official phone:** (318) 212-8780

## Contact information

- **Practice address:** 1811 E BERT KOUN LOOP, SUITE 480, SHREVEPORT, LA 71105-5740
- **Practice address phone:** (318) 212-2810
- **Practice address fax:** (318) 212-2818
- **Mailing address:** 1811 E BERT KOUN LOOP, SUITE 480, SHREVEPORT, LA 71105-5740
- **Mailing address phone:** (318) 212-2810
- **Mailing address fax:** (318) 212-2818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/23/2014
- **Last updated:** 07/23/2014