# WK ACADEMIC MEDICINE CLINIC

> 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992375844
- **Authorized official:** MATHEW WHEELER (REVENUE CONTRACT MANAGER)
- **Authorized official phone:** (318) 716-4939

## Contact information

- **Practice address:** 2751 ALBERT L BICKNELL DR STE 2D, SHREVEPORT, LA 71103-3939
- **Practice address phone:** (318) 212-4232
- **Practice address fax:** (318) 212-4257
- **Mailing address:** 2751 ALBERT L BICKNELL DR STE 2D, SHREVEPORT, LA 71103-3939
- **Mailing address phone:** (318) 212-4232
- **Mailing address fax:** (318) 212-4257

## Taxonomy

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

## Other

- **Enumeration date:** 07/01/2021
- **Last updated:** 02/28/2022