# WILLIS-KNIGHTON MEDICAL CENTER, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WILLIS-KNIGHTON MEDICAL CENTER, INC.
- **Other names:** WK Regional Orthopedic and Sports Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1437441698
- **Legal business name:** WILLIS-KNIGHTON MEDICAL CENTER, INC.
- **Authorized official:** GREG J. GAVIN (NETWORK ADMINISTRATOR)
- **Authorized official phone:** (318) 212-8780

## Contact information

- **Practice address:** 2520 BERT KOUNS LOOP, SUITE 105, SHREVEPORT, LA 71118-3130
- **Practice address phone:** (318) 212-5886
- **Practice address fax:** (318) 212-5889
- **Mailing address:** 1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
- **Mailing address phone:** (318) 212-5886
- **Mailing address fax:** (318) 212-5889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/06/2011
- **Last updated:** 12/21/2011