Organization
WK OB-GYN CONCEPTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN (NETWORK ADMINISTRATION)
(318) 212-4232
Entity
Organization
Contact information
Practice address
7853 YOUREE DR, SHREVEPORT, LA 71105-5505
(318) 212-2835
(318) 212-2839
Mailing address
7853 YOUREE DR, SHREVEPORT, LA 71105-5505
(318) 212-2835
(318) 212-2839
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
09/11/2012
Last updated
09/11/2012
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