# JENNIFER WILKINSON PA-C AND WILLIS-KNIGHTON MEDICAL CENTER

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

## Provider details

- **NPI number:** 1407898729
- **Authorized official:** GREG J. GAVIN (NETWORK ADMINISTRATOR)
- **Authorized official phone:** (318) 212-8780

## Contact information

- **Practice address:** 2300 HOSPITAL DR, SUITE 200, BOSSIER CITY, LA 71111-2394
- **Practice address phone:** (318) 212-7830
- **Practice address fax:** (318) 212-7835
- **Mailing address:** 2300 HOSPITAL DR, SUITE 200, BOSSIER CITY, LA 71111-2394
- **Mailing address phone:** (318) 212-7830
- **Mailing address fax:** (318) 212-7835

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 06/12/2006
- **Last updated:** 08/22/2020