Organization
WK SOUTH HOSPITALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4232
Entity
Organization
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 320, SHREVEPORT, LA 71118-3133
(318) 212-5990
(318) 212-5887
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 320, SHREVEPORT, LA 71118-3133
(318) 212-5990
(318) 212-5887
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1139092
—
LA
Enumeration date
05/30/2008
Last updated
06/17/2016
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