Organization
WILLIS KNIGHTON MEDICAL CENTER, INC.
Active
Other names
WK Renal Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE WARD (CFO)
(318) 212-4384
Entity
Organization
Contact information
Practice address
1111 LINE AVENUE, SHREVEPORT, LA 71101
(318) 212-4759
Mailing address
2600 GREENWOOD RD, SHREVEPORT, LA 71103-3908
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/10/2007
Last updated
01/08/2025
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