Organization
WK NORTHWEST LOUISIANA INFECTIOUS DISEASE CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 424-4232
Entity
Organization
Contact information
Practice address
2551 GREENWOOD RD, SUITE 150, SHREVEPORT, LA 71103-3981
(318) 212-6888
(318) 212-6890
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-8946
(318) 212-1153
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
07/22/2011
Last updated
10/16/2012
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