# WKB FAMILY MEDICINE ASSOCIATES

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

## Provider details

- **NPI number:** 1972746097
- **Authorized official:** GREG J. GAVIN (NETWORK ADMINISTRATOR)
- **Authorized official phone:** (318) 212-4232

## Contact information

- **Practice address:** 2449 HOSPITAL DR, SUITE 420, BOSSIER CITY, LA 71111-2399
- **Practice address phone:** (318) 212-7839
- **Mailing address:** 2449 HOSPITAL DR, SUITE 420, BOSSIER CITY, LA 71111-2399
- **Mailing address phone:** (318) 212-7839

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/20/2009
- **Last updated:** 06/08/2012