Organization
NANCY GERMANY MD AND WILLIS-MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 687-5500
Entity
Organization
Contact information
Practice address
6821 PINES RD, SUITE 100, SHREVEPORT, LA 71129-2547
(318) 687-5500
(318) 687-5503
Mailing address
6821 PINES RD, SUITE 100, SHREVEPORT, LA 71129-2547
(318) 687-5500
(318) 687-5503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/24/2006
Last updated
08/05/2009
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