Organization
WK SOUTH SHREVEPORT WOMENS HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4232
Entity
Organization
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 207, SHREVEPORT, LA 71118-3133
(318) 212-5343
(318) 212-5360
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 207, SHREVEPORT, LA 71118-3133
(318) 212-5343
(318) 212-5360
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
10/23/2009
Last updated
06/08/2012
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