Organization
INDIRA SASTRY AND WILLIS-KNIGHTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-5976
Entity
Organization
Contact information
Practice address
2533 BERT KOUNS LOOP, SUITE 106, SHREVEPORT, LA 71118-3158
(318) 212-5976
(318) 212-5986
Mailing address
2533 BERT KOUNS LOOP, SUITE 106, SHREVEPORT, LA 71118-3158
(318) 212-5976
(318) 212-5986
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1448877
—
LA
Enumeration date
04/21/2006
Last updated
10/01/2013
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