Organization
VERERANDO R DEL MUNDO MD AND WILLIS-KNIGHTON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-3770
Entity
Organization
Contact information
Practice address
8001 YOUREE DR, SUITE 550, SHREVEPORT, LA 71115-2302
(318) 212-3770
(318) 212-3758
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-8795
(318) 212-4025
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/23/2006
Last updated
07/28/2009
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