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Organization
WK RED RIVER INTERNAL MEDICINE
Active
Organization
WK RED RIVER INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4132
Entity
Organization
Contact information
Practice address
2300 HOSPITAL DR, SUITE 320, BOSSIER CITY, LA 71111-2394
(318) 212-7848
(318) 212-7855
Mailing address
2300 HOSPITAL DR, SUITE 320, BOSSIER CITY, LA 71111-2394
(318) 212-7848
(318) 212-7855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/14/2010
Last updated
06/11/2012
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