Organization · Type 2 NPI

Willis-Knighton Medical Center, Inc

Neurology Physician · Shreveport, LA

NPI number 1700165891 Active

Practice location

2551 Greenwood Rd, Suite 240
Shreveport, LA 71103-3981

Fax (318) 212-8680

Specialties and licenses

Taxonomy	Code	License
Neurology Physician Primary	2084N0400X	None listed

Neurology Physician: A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

44 other providers at this address

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NPI record

NPI: 1700165891
Entity type: Organization (Type 2)
Issued: Aug 8, 2011
Last updated: Nov 23, 2011
Status: Active
Subpart: Yes of Willis-Knighton Medical Center, Inc.

Other names

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WK Tristate Neurology Clinic · doing business as

Authorized official

Greg J. Gavin
Network Administrator
(318) 212-4232

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1700165891

Willis-Knighton Medical Center, Inc's National Provider Identifier is 1700165891, issued on Aug 8, 2011. The primary taxonomy on file is Neurology Physician (2084N0400X), and the practice location is in Shreveport, LA. The record was last updated on Nov 23, 2011.