Wk Shreveport Breast Center

NPI #1972532166 in Shreveport, Louisiana

Provider Information

NPI Number: 1972532166
Entity Type: Organization
Organization Name: Wk Shreveport Breast Center
Primary Specialty: Surgery
Enumeration Date: Jul 1, 2006
Last Updated: Jun 8, 2012

Practice Location

Address: 8001 YOUREE DR
Address 2: SUITE 960
City: Shreveport
State: Louisiana
ZIP Code: 71115-2302
Phone: (318) 212-3706

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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