Organization
WK PREFERRED PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW WHEELER (REVENUE CONTRACT MANAGER)
(318) 212-8299
Entity
Organization
Contact information
Practice address
2300 HOSPITAL DR STE 120, BOSSIER CITY, LA 71111-2193
(318) 212-7982
(318) 212-7989
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-8951
(318) 212-6752
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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