Wk South Shreveport Family Practice
NPI #1346426913 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1346426913
- Entity Type
- Organization
- Organization Name
- Wk South Shreveport Family Practice
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jan 14, 2008
- Last Updated
- Jun 8, 2012
Practice Location
- Address
- 2520 BERT KOUNS LOOP STE 102
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71118-3130
- Phone
- (318) 212-5972
Authorized Official
- Name
- GREG J. GAVIN
- Title
- NETWORK ADMINISTRATOR
- Phone
- (318) 212-4232
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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