Organization
WK URGENT CARE CENTER-PIERREMONT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN RANDALL (VP ADMINISTRATION)
(318) 212-3520
Entity
Organization
Contact information
Practice address
1666 E BERT KOUNS LOOP, SUITE 105, SHREVEPORT, LA 71105-5714
(318) 212-3520
(318) 212-3525
Mailing address
1666 E BERT KOUNS LOOP, SUITE 105, SHREVEPORT, LA 71105-5714
(318) 212-3520
(318) 212-3525
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1440671
—
LA
Enumeration date
06/22/2006
Last updated
10/27/2015
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