Organization
WK PIERREMONT CARDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN (NETWORK ADMINISTRATOR)
(318) 212-8780
Entity
Organization
Contact information
Practice address
1811 E BERT KOUN LOOP, SUITE 210, SHREVEPORT, LA 71105-5740
(318) 212-8780
(318) 212-6752
Mailing address
1811 E BERT KOUN LOOP, SUITE 210, SHREVEPORT, LA 71105-5740
(318) 212-8780
(318) 212-6752
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
03/19/2015
Last updated
10/27/2015
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