Organization
WILLIS-KNIGHTON MEDICAL CENTER, INC.
Active
Parent organization
WILLIS-KNIGHTON MEDICAL CENTER, INC.
Other names
WK Regional Orthopedic and Sports Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIS-KNIGHTON MEDICAL CENTER, INC.
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-8780
Entity
Organization
Contact information
Practice address
2520 BERT KOUNS LOOP, SUITE 105, SHREVEPORT, LA 71118-3130
(318) 212-5886
(318) 212-5889
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-5886
(318) 212-5889
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
05/06/2011
Last updated
12/21/2011
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