Organization
WK NORTH LAPAROSCOPIC SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4232
Entity
Organization
Contact information
Practice address
2751 ALBERT L BICKNELL DR, SUITE 3D, SHREVEPORT, LA 71103-3920
(318) 221-4755
(318) 424-3642
Mailing address
2751 ALBERT L BICKNELL DR, SUITE 3D, SHREVEPORT, LA 71103-3920
(318) 221-4755
(318) 424-3642
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
06/26/2013
Last updated
06/28/2013
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