Willis-Knighton Medical Center Mark Richard Mainous
NPI #1720014145 in Bossier City, Louisiana
Provider Information
- NPI Number
- 1720014145
- Entity Type
- Organization
- Organization Name
- Willis-Knighton Medical Center Mark Richard Mainous
- Primary Specialty
- Surgery - Surgical Critical Care
- Enumeration Date
- Jun 25, 2006
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 2400 HOSPITAL DR
- Address 2
- SUITE 310
- City
- Bossier City
- State
- Louisiana
- ZIP Code
- 71111-2385
- Phone
- (318) 212-7810
Authorized Official
- Name
- GREG J. GAVIN
- Title
- NETWORK ADMINISTRATOR
- Phone
- (318) 212-7810
Specialties & Taxonomy Codes
| Specialty |
|---|
| Surgery - Surgical Critical Care — Surgical Critical Care |
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