Organization
SAM F BURKE JR MD AND WILLIS-KNIGHTON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN (NETWORK ADMINISTRATOR)
(318) 688-6493
Entity
Organization
Contact information
Practice address
2508 BERT KOUNS LOOP, SUITE 304, SHREVEPORT, LA 71118-3133
(318) 688-6493
(318) 688-9446
Mailing address
2508 BERT KOUNS LOOP, SUITE 304, SHREVEPORT, LA 71118-3133
(318) 688-6493
(318) 688-9446
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
06/21/2006
Last updated
01/16/2008
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