Organization
WK BOSSIER HOSPITALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4232
Entity
Organization
Contact information
Practice address
2400 HOSPITAL DR, SUITE 130, BOSSIER CITY, LA 71111-2385
(318) 212-7990
(318) 212-7995
Mailing address
2400 HOSPITAL DR, SUITE 130, BOSSIER CITY, LA 71111-2385
(318) 212-7990
(318) 212-7995
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1178845
—
LA
Enumeration date
06/19/2008
Last updated
06/11/2012
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