# WK NORTHWEST INTERNAL MEDICINE

> 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
- **Other names:** Willis Knighton Internal Medicine Pierremont Suite 550
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891009437
- **Authorized official:** JARED THOMAS BEVILLE (VP WK PHYSICIAN NETWORK)
- **Authorized official phone:** (318) 719-4950

## Contact information

- **Practice address:** 8001 YOUREE DR STE 550, SHREVEPORT, LA 71115-2332
- **Practice address phone:** (318) 212-2984
- **Practice address fax:** (318) 212-3404
- **Mailing address:** 8001 YOUREE DR STE 550, SHREVEPORT, LA 71115-2332
- **Mailing address phone:** (318) 212-2984
- **Mailing address fax:** (318) 212-3404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/05/2010
- **Last updated:** 10/01/2024