# WK FAMILY MEDICINE RUSTON

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

## Provider details

- **NPI number:** 1295435337
- **Authorized official:** MARY J WARD (SR. VP FINANCE)
- **Authorized official phone:** (318) 716-4939

## Contact information

- **Practice address:** 2916 N TRENTON ST, RUSTON, LA 71270-2444
- **Practice address phone:** (318) 254-2892
- **Practice address fax:** (318) 635-9857
- **Mailing address:** 2916 N TRENTON ST, RUSTON, LA 71270-2444
- **Mailing address phone:** (318) 254-2892
- **Mailing address fax:** (318) 635-9857

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2023
- **Last updated:** 03/07/2023