Organization
LESLIE SEWELL MD & WILLIS-KNIGHTON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-7930
Entity
Organization
Contact information
Practice address
2300 HOSPITAL DR, SUITE 330, BOSSIER CITY, LA 71111-2394
(318) 212-7848
(318) 212-7855
Mailing address
2300 HOSPITAL DR, SUITE 330, BOSSIER CITY, LA 71111-2394
(318) 212-7848
(318) 212-7855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/01/2006
Last updated
07/17/2007
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