Organization
WK RADIATION ONCOLOGY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN (NETWORK ADMINISTRATOR)
(318) 212-8780
Entity
Organization
Contact information
Practice address
2600 KINGS HWY, SHREVEPORT, LA 71103-3950
(318) 212-4639
(318) 212-8305
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-8977
(318) 212-4153
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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