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Organization
WK BOSSIER RIVER CITIES INTERVENTIONAL PAIN SPECIALISTS
Active
Organization
WK BOSSIER RIVER CITIES INTERVENTIONAL PAIN SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4232
Entity
Organization
Contact information
Practice address
2449 HOSPITAL DR, SUITE 300, BOSSIER CITY, LA 71111-2399
(318) 212-7960
(318) 212-7965
Mailing address
2449 HOSPITAL DR, SUITE 300, BOSSIER CITY, LA 71111-2399
(318) 212-7960
(318) 212-7965
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
10/02/2009
Last updated
06/08/2012
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