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Organization

WK SPINE & PAIN SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GREG J GAVIN (ADMINISTRATOR)
(318) 212-8951
Entity
Organization

Contact information

Practice address
2449 HOSPITAL DR, SUITE 300, BOSSIER CITY, LA 71111-2399
(318) 212-7960
(318) 212-7965
Mailing address
2449 HOSPITAL DR, SUITE 300, BOSSIER CITY, LA 71111-2399
(318) 212-7960
(318) 212-7965

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
MD.199995
LA

Other

Enumeration date
03/09/2016
Last updated
03/09/2016
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