Organization
WKB FAMILY MEDICINE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4232
Entity
Organization
Contact information
Practice address
2449 HOSPITAL DR, SUITE 420, BOSSIER CITY, LA 71111-2399
(318) 212-7839
Mailing address
2449 HOSPITAL DR, SUITE 420, BOSSIER CITY, LA 71111-2399
(318) 212-7839
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/20/2009
Last updated
06/08/2012
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