NPI 1588806970

Wk North Dermatology Clinic

Organisation Dermatology Physician Shreveport, LA

Practice location

Address: 2751 Albert L Bicknell Dr Suite 2-D, Shreveport, LA 71103-3920
Phone: (318) 221-2623
Fax: (318) 424-9850
Mailing address: 1202 Louisiana Ave, Shreveport, LA 71101-3910

Authorised official

Name: Greg J. Gavin
Title: Network Administrator
Phone: (318) 212-4232

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Louisiana →

Registry record

NPI: 1588806970
Entity type: Organization
NPI issued: 31 Mar 2009
Record last updated: 14 Aug 2013

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.