Organization
WK PINNACLE GASTROENTEROLOGY
Active
Organization
WK PINNACLE GASTROENTEROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4571
Entity
Organization
Contact information
Practice address
2551 GREENWOOD RD, SUITE 350, SHREVEPORT, LA 71103-3981
(318) 212-8710
(318) 212-8699
Mailing address
2551 GREENWOOD RD, SUITE 350, SHREVEPORT, LA 71103-3981
(318) 212-8710
(318) 212-8699
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1448834
—
LA
Enumeration date
11/28/2005
Last updated
06/08/2012
Update your record
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