Organization
WILLIS-KNIGHTON MEDICAL CENTER, INC.
Active
Parent organization
WILLIS-KNIGHTON MEDICAL CENTER, INC.
Other names
North Bossier Internal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIS-KNIGHTON MEDICAL CENTER, INC.
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-8780
Entity
Organization
Contact information
Practice address
2400 HOSPITAL DR, SUITE 350, BOSSIER CITY, LA 71111-2385
(318) 212-7930
(318) 212-7935
Mailing address
2400 HOSPITAL DR, SUITE 350, BOSSIER CITY, LA 71111-2385
(318) 212-7930
(318) 212-7935
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452866
—
LA
Enumeration date
06/11/2006
Last updated
12/20/2011
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