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Organization
WK HAUGHTON MEDICAL GROUP
Active
Organization
WK HAUGHTON MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 649-2495
Entity
Organization
Contact information
Practice address
5751 SHED RD STE 120, BOSSIER CITY, LA 71111-5662
(318) 935-1992
(318) 935-1925
Mailing address
5751 SHED RD STE 120, BOSSIER CITY, LA 71111-5662
(318) 935-1992
(318) 935-1925
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/29/2006
Last updated
05/19/2022
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