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Organization
WK INTERNAL MEDICINE AND PEDIATRIC SPECIALISTS
Active
Organization
WK INTERNAL MEDICINE AND PEDIATRIC SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED BEVILLE (VP PHYSICIAN NETWORK)
(318) 716-4891
Entity
Organization
Contact information
Practice address
5751 SHED RD STE 120, BOSSIER CITY, LA 71111-5662
(318) 935-1922
(318) 935-1925
Mailing address
5751 SHED RD STE 120, BOSSIER CITY, LA 71111-5662
(318) 935-1922
(318) 935-1925
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
02/26/2015
Last updated
09/10/2024
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