Organization
WK RED RIVER INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-4132
Entity
Organization
Contact information
Practice address
2300 HOSPITAL DR, SUITE 320, BOSSIER CITY, LA 71111-2394
(318) 212-7848
(318) 212-7855
Mailing address
2300 HOSPITAL DR, SUITE 320, BOSSIER CITY, LA 71111-2394
(318) 212-7848
(318) 212-7855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/14/2010
Last updated
06/11/2012
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