WK Adult Medicine Specialists

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

WK ADULT MEDICINE SPECIALISTS

Practice address

2508 Bert Koun Loop Ste 300
Shreveport, LA 71118-3100

Phone

(318) 212-5757

Fax

(318) 212-5779

NPI assigned

Jul 19, 2018

Last updated

Jul 19, 2018By the provider in NPPES

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) 212-8951

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": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1548746852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 BERT KOUN LOOP STE 300",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183100",
            "telephone_number": "318-212-5757",
            "fax_number": "318-212-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 BERT KOUN LOOP STE 300",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183100",
            "telephone_number": "318-212-5757",
            "fax_number": "318-212-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK ADULT MEDICINE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "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": "318-212-8951"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor Wisniewski-Top, PT, DPT
• Shila Withers
• Witte Family Dentistry, LLC
• Savanna Taelor Witthoeft
• WK Academic Medicine Clinic
• WK Advanced Cardiac Imaging
• WK Advanced Laparoscopic and Robotic Surgery Specialists
• WK Advanced Surgery Center
• WK Allergy Asthma & Immunology Center
• WK Ark-la-Tex Neonatology

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.