| WK Physicians Network | |
|
1202 Louisiana Ave Shreveport LA 71101-3910 | |
| (318) 212-8946 | |
| (318) 212-4153 |
| Full Name | WK Physicians Network |
|---|---|
| Speciality | Internal Medicine |
| Location | 1202 Louisiana Ave, Shreveport, Louisiana |
| Authorized Official Name and Position | Greg J Gavin (NETWORK ADMINISTRATOR) |
| Authorized Official Contact | 3182128780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| WK Physicians Network 1202 Louisiana Ave Shreveport LA 71101-3910 Ph: (318) 212-8946 | WK Physicians Network 1202 Louisiana Ave Shreveport LA 71101-3910 Ph: (318) 212-8946 |
| NPI Number | 1841222544 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 06/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841222544 | NPI | - | NPPES |
| 1447595 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
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