WK Ctr for Ear Nose and Throat Disorders

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

WK CTR FOR EAR NOSE AND THROAT DISORDERS

Practice address

2300 Hospital Dr
Suite 460
Bossier City, LA 71111-2394

Phone

(318) 212-7953

Fax

(318) 212-7955

NPI assigned

Apr 10, 2013

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) 212-4232

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Willis Knighton Medical Center, Inc.

  dba WK Renal Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Shreveport, LA
  • NPI 1003020579

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1356784359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "SUITE 460",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112394",
            "telephone_number": "318-212-7953",
            "fax_number": "318-212-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "SUITE 460",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112394",
            "telephone_number": "318-212-7953",
            "fax_number": "318-212-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK CTR FOR EAR NOSE AND THROAT DISORDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "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": "318-212-4232"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WK Bossier Pulmonary & Critical Care Clinic
• WK Bossier River Cities Interventional Pain Specialists
• WK Bossier Surgical Associates
• WK Bossier Urology Clinic
• WK Center for Ear Nose and Throat Disorders
• WK Dermatology Clinic
• WK Endocrine Specialists
• WK Haughton Medical Group
• WK Internal Medicine and Pediatric Specialists
• WK Louisiana Family Practice

• Otolaryngology Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Otolaryngology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.