D Gene Mack Jr MD and Willis-Knighton Medical Center

NPI #1134295520 in Shreveport, Louisiana

Provider Information

NPI Number: 1134295520
Entity Type: Organization
Organization Name: D Gene Mack Jr MD and Willis-Knighton Medical Center
Primary Specialty: Pediatrics
Enumeration Date: Nov 28, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1799 E BERT KOUNS INDUSTRIAL LOOP
City: Shreveport
State: Louisiana
ZIP Code: 71105-5561
Phone: (318) 797-9000

Authorized Official

Name: GREG J GAVIN
Title: NETWORK ADMINISTRATOR
Phone: (318) 212-4232

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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