WK Physicians Network

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WK PHYSICIANS NETWORK

Practice address

1202 Louisiana Ave
Shreveport, LA 71101-3910

Phone

(318) 212-8946

Fax

(318) 212-4153

NPI assigned

Jul 6, 2006

Last updated

Jun 12, 2012By 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) 212-8780

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1841222544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8946",
            "fax_number": "318-212-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8946",
            "fax_number": "318-212-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK PHYSICIANS NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2012-06-12",
        "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"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447595",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WK Pediatric Healthcare Associates
• WK Pediatric Intensivist
• WK Pediatric Pulmonology Specialists
• WK Pediatric Surgical Associates
• WK Pelvic & Reconstructive Surgery
• WK Pierre Ave Community Health Education and Wellness Center
• WK Pierremont Associates in Internal Medicine
• WK Pierremont Cardiology
• WK Pierremont Endocrine Center
• WK Pierremont ENT

• 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 Jun 12, 2012; 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.