Organization
WK BOSSIER UROLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN (NETWORK ADMINISTRATOR)
(318) 212-7788
Entity
Organization
Contact information
Practice address
2300 HOSPITAL DR, SUITE 340, BOSSIER CITY, LA 71111-2394
(318) 212-7788
(318) 212-7795
Mailing address
2300 HOSPITAL DR, SUITE 340, BOSSIER CITY, LA 71111-2394
(318) 212-7788
(318) 212-7795
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
07/05/2006
Last updated
08/22/2020
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