NPIMap

Organization Active NPI

Kirk W Cofran MD and Willis-Knighton Medical Center

  • Family Medicine Physician
  • Shreveport, LA
National Provider Identifier
1407896285
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KIRK W COFRAN MD AND WILLIS-KNIGHTON MEDICAL CENTER
Practice address
2520 Bert Kouns Loop
Suite 102
Shreveport, LA 71118-3130
Phone
(318) 688-0173
Fax
(318) 632-5369
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2520 Bert Kouns Loop
Suite 102
Shreveport, LA 71118-3130

Mailing address

2520 Bert Kouns Loop
Suite 102
Shreveport, LA 71118-3130
Phone (318) 688-0173

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1407896285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 BERT KOUNS LOOP",
            "address_2": "SUITE 102",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183130",
            "telephone_number": "318-688-0173",
            "fax_number": "318-632-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 BERT KOUNS LOOP",
            "address_2": "SUITE 102",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183130",
            "telephone_number": "318-688-0173",
            "fax_number": "318-632-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRK W COFRAN MD AND WILLIS-KNIGHTON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-11-21",
        "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",
        "authorized_official_name_suffix": "IX"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "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 Nov 21, 2007; 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.