Organization
WK FAMILY MEDICINE PARTNERS AT PIERREMONT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J GAVIN (NETWORK ADMINISTRATOR)
(318) 212-8780
Entity
Organization
Contact information
Practice address
1811 E BERT KOUN LOOP, STE 120, SHREVEPORT, LA 71105-5740
(318) 212-2841
(318) 212-2759
Mailing address
1811 E BERT KOUN LOOP, STE 120, SHREVEPORT, LA 71105-5740
(318) 212-2841
(318) 212-2759
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/22/2016
Last updated
08/11/2016
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