Organization Active NPI

WK North Laparoscopic Surgical Associates

  • Surgery Physician
  • Shreveport, LA
National Provider Identifier
1255770467
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
WK NORTH LAPAROSCOPIC SURGICAL ASSOCIATES
Practice address
1202 Louisiana Ave
Shreveport, LA 71101-3910
Phone
(318) 212-8780
Fax
(318) 212-6752
NPI assigned
Jun 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1202 Louisiana Ave
Shreveport, LA 71101-3910

Mailing address

1202 Louisiana Ave
Shreveport, LA 71101-3910
Phone (318) 212-8780

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371686400000",
    "number": "1255770467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK NORTH LAPAROSCOPIC SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-20",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-8780"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.