Organization
KIRK W COFRAN MD AND WILLIS-KNIGHTON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN IX (NETWORK ADMINISTRATOR)
(318) 212-8780
Entity
Organization
Contact information
Practice address
2520 BERT KOUNS LOOP, SUITE 102, SHREVEPORT, LA 71118-3130
(318) 688-0173
(318) 632-5369
Mailing address
2520 BERT KOUNS LOOP, SUITE 102, SHREVEPORT, LA 71118-3130
(318) 688-0173
(318) 632-5369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/08/2006
Last updated
11/21/2007
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