| Wk Louisiana Family Practice | |
|
2300 Hospital Dr Suite 200 Bossier City LA 71111-2394 | |
| (318) 212-7830 | |
| (318) 212-7835 |
| Full Name | Wk Louisiana Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 2300 Hospital Dr, Bossier City, Louisiana |
| Authorized Official Name and Position | Greg J. Gavin (NETWORK ADMINISTRATOR) |
| Authorized Official Contact | 3182128780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wk Louisiana Family Practice 2300 Hospital Dr Suite 200 Bossier City LA 71111-2394 Ph: (318) 212-7830 | Wk Louisiana Family Practice 2300 Hospital Dr Suite 200 Bossier City LA 71111-2394 Ph: (318) 212-7830 |
| NPI Number | 1164464889 |
|---|---|
| Provider Enumeration Date | 06/11/2006 |
| Last Update Date | 06/08/2012 |
| Medicare PECOS PAC ID | 3375557929 |
|---|---|
| Medicare Enrollment ID | O20060202000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164464889 | NPI | - | NPPES |
| 1452858 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Melanie M Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659317410 PECOS PAC ID: 7517871452 Enrollment ID: I20031115000049 |
| Provider Name | Sanjaykumar B Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740226505 PECOS PAC ID: 3971556127 Enrollment ID: I20050228000591 |
| Provider Name | Daniel L Payne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073557542 PECOS PAC ID: 4082641097 Enrollment ID: I20050721000374 |
| Provider Name | Scott L Mighell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093759854 PECOS PAC ID: 5496769507 Enrollment ID: I20060127000513 |
| Provider Name | Ricky Garland Davidson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942246707 PECOS PAC ID: 7911911037 Enrollment ID: I20060127000542 |
| Provider Name | Allen L Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033155890 PECOS PAC ID: 2062426638 Enrollment ID: I20060203000203 |
| Provider Name | Ted Warren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306878509 PECOS PAC ID: 3971693011 Enrollment ID: I20071213000342 |
| Provider Name | John P Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437234903 PECOS PAC ID: 9234324914 Enrollment ID: I20101108000534 |
| Provider Name | Robert C Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972863231 PECOS PAC ID: 9436382025 Enrollment ID: I20140506001746 |
| Provider Name | Taylor Curry Bradford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790303352 PECOS PAC ID: 3971914862 Enrollment ID: I20221118000115 |
Rapid Care Of Bossier Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5015 Shed Rd, Suite 400, Bossier City, LA 71111 Phone: 318-584-7301 Fax: 318-741-4496 | |
Charles A Powers Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2400 Hospital Dr, Suite 420, Bossier City, LA 71111 Phone: 318-212-7910 Fax: 318-212-7915 | |
Willow Chute Medical, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4910 Airline Dr, Bossier City, LA 71111 Phone: 318-349-3921 | |
Abaka Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4438 Viking Dr, Bossier City, LA 71111 Phone: 318-918-0015 Fax: 318-963-0015 | |
Allen Cox Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2300 Hospital Dr, Suite 200, Bossier City, LA 71111 Phone: 318-212-7830 Fax: 318-212-7835 | |
Wk Endocrine Specialists Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2449 Hospital Dr, Suite 400, Bossier City, LA 71111 Phone: 318-212-7902 Fax: 318-212-7905 | |
Sanjay Kumar Shah Md & Willis-knighton Medical Center Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2300 Hospital Dr, Suite 200, Bossier City, LA 71111 Phone: 318-212-7830 Fax: 318-212-7835 |