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WK INTERNAL MEDICINE AND PEDIATRIC SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JARED BEVILLE (VP PHYSICIAN NETWORK)
(318) 716-4891
Entity
Organization

Contact information

Practice address
5751 SHED RD STE 120, BOSSIER CITY, LA 71111-5662
(318) 935-1922
(318) 935-1925
Mailing address
5751 SHED RD STE 120, BOSSIER CITY, LA 71111-5662
(318) 935-1922
(318) 935-1925

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
208000000X
Pediatrics Physician

Other

Enumeration date
02/26/2015
Last updated
09/10/2024
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