# WK URGENT CARE CENTER-PIERREMONT

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

## Provider details

- **NPI number:** 1639115132
- **Authorized official:** STEVEN RANDALL (VP ADMINISTRATION)
- **Authorized official phone:** (318) 212-3520

## Contact information

- **Practice address:** 1666 E BERT KOUNS LOOP, SUITE 105, SHREVEPORT, LA 71105-5714
- **Practice address phone:** (318) 212-3520
- **Practice address fax:** (318) 212-3525
- **Mailing address:** 1666 E BERT KOUNS LOOP, SUITE 105, SHREVEPORT, LA 71105-5714
- **Mailing address phone:** (318) 212-3520
- **Mailing address fax:** (318) 212-3525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2083X0100X | Occupational Medicine Physician | — | NULL | — |
| 2083X0100X | Occupational Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 06/22/2006
- **Last updated:** 10/27/2015