Organization
WK NORTH GYNECOLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4232
Entity
Organization
Contact information
Practice address
2551 GREENWOOD RD, SUITE 310, SHREVEPORT, LA 71103-3981
(318) 222-1902
(318) 678-0974
Mailing address
2551 GREENWOOD RD, SUITE 310, SHREVEPORT, LA 71103-3981
(318) 222-1902
(318) 678-0974
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Enumeration date
05/16/2007
Last updated
06/08/2012
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