Jack Berg MD & Willis-Knighton Medical Center
NPI #1396785150 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1396785150
- Entity Type
- Organization
- Organization Name
- Jack Berg MD & Willis-Knighton Medical Center
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jun 8, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 7813 YOUREE DR
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71105-5505
- Phone
- (318) 212-3830
Authorized Official
- Name
- GREG J. GAVIN
- Title
- NETWORK ADMINISTRATOR
- Phone
- (318) 212-8780
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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