NPI 1164464889

Wk Louisiana Family Practice

Organisation Family Medicine Physician Bossier City, LA

Practice location

Address: 2300 Hospital Dr Suite 200, Bossier City, LA 71111-2394
Phone: (318) 212-7830
Fax: (318) 212-7835

Authorised official

Name: Greg J. Gavin
Title: Network Administrator
Phone: (318) 212-8780

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Louisiana →

Registry record

NPI: 1164464889
Entity type: Organization
NPI issued: 11 Jun 2006
Record last updated: 8 Jun 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.