Organization
WK OIL CITY MEDICAL 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
103 SOUTH HWY 1, OIL CITY, LA 71061
(318) 995-6504
(318) 995-6535
Mailing address
103 SOUTH HWY 1, OIL CITY, LA 71061
(318) 995-6504
(318) 995-6535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014991
—
LA
Enumeration date
05/08/2007
Last updated
06/08/2012
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