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Organization

WK PIERREMONT ENDOCRINE CENTER

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 480, SHREVEPORT, LA 71105-5740
(318) 212-2810
(318) 212-2818
Mailing address
1811 E BERT KOUN LOOP, SUITE 480, SHREVEPORT, LA 71105-5740
(318) 212-2810
(318) 212-2818

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary

Other

Enumeration date
07/23/2014
Last updated
07/23/2014
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