WK Womens Health Associates

Organization Active NPI Obstetrics & Gynecology Physician · Bossier City, LA

NPI 1790790467 · NPPES record last updated Jun 8, 2012

Key facts

NPI
1790790467
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
WK WOMENS HEALTH ASSOCIATES
Practice address
2400 Hospital Dr
Suite 240
Bossier City, LA 71111-2385
Phone
(318) 742-5800
Fax
(318) 741-3902
NPI assigned
Jul 30, 2006
Organization subpart
No

Authorized official

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

Member of 1

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

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20061113000050 LA Part B Supplier - Clinic/Group Practice 2668470345 Receives reassigned benefits from 7 practitioners
Practice locations: Bossier City, LA

National Provider Directory

Locations

2400 Hospital Dr
Ste 240
Bossier City, LA 71111
Phone (318) 742-1795

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207V00000X Yes

Addresses

Primary practice location

2400 Hospital Dr
Suite 240
Bossier City, LA 71111-2385

Mailing address

2400 Hospital Dr
Suite 240
Bossier City, LA 71111-2385
Phone (318) 742-5800

Other identifiers

IdentifierTypeStateIssuer
1448966MedicaidLA

Other providers in Bossier City, LA

All providers in Bossier City, LA · Obstetrics & Gynecology Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.