J Woodfin Wilson MD & Willis-Knighton Medical Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

J WOODFIN WILSON MD & WILLIS-KNIGHTON MEDICAL CENTER

Practice address

8001 Youree Dr
Suite 450
Shreveport, LA 71115-2302

Phone

(318) 212-3952

Fax

(318) 212-3955

NPI assigned

Jul 6, 2006

Organization subpart

No

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) 212-3952

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265463285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "SUITE 450",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-212-3952",
            "fax_number": "318-212-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "SUITE 450",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-212-3952",
            "fax_number": "318-212-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J WOODFIN WILSON MD & WILLIS-KNIGHTON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "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": "318-212-3952"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.