WKB Family Medicine Associates
Organization Active NPI Family Medicine Physician · Bossier City, LA
NPI 1972746097 · NPPES record last updated Jun 8, 2012
Key facts
- NPI
- 1972746097
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- WKB FAMILY MEDICINE ASSOCIATES
- Practice address
- 2449 Hospital Dr
Suite 420
Bossier City, LA 71111-2399 - Phone
- (318) 212-7839
- NPI assigned
- Apr 20, 2009
- Organization subpart
- No
Authorized official
- Name
- Greg J. Gavin
- Title
- Network Administrator
- Phone
- (318) 212-4232
Member of 1
Practitioners 26
-
Sarah Estess, FNP
-
Jason K Milligan, M.D.
-
Clint N. Wilson, M.D.
-
Abigail Davis Bogan, PA-C
-
Colleen Hannon Cline, PA-C
-
Sarah Tucker Allen, P.A.
-
Calvin D. Alexander, M.D.
-
Steven Allen Conrad, M.D.
-
Ronald S Lambert, MD
-
Catrina Lewis, FNP
-
Richard Louis Morrison, M.D.
-
Paul Douglas Myers, RN,NP
-
Raghu P Nathan, MD
-
Lea J. Rimmer, NP
-
Gerardo Santos San Pedro, M.D.
-
Chase C White, NP
-
Laura Michelle Mahaffey, A.C.N.P.
-
Toby Ray Smith, MD
-
Askin Uysal, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090810000022 | LA | Part B Supplier - Clinic/Group Practice | 4183777147 |
Receives reassigned benefits from 6 practitioners Practice locations: Bossier City, LA |
National Provider Directory
Locations
5341 Airline Dr
Ste 130
Bossier City, LA 71111
Phone (318) 935-1820
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
2449 Hospital Dr
Suite 420
Bossier City, LA 71111-2399
Mailing address
2449 Hospital Dr
Suite 420
Bossier City, LA 71111-2399
Phone (318) 212-7839
Other providers in Bossier City, LA
- WK Spine & Pain Specialists
- WK Swan Lake Diabetes & Endocrinology
- WK Urgent Care Center - Bossier
- WK Womens Health Associates
- WK Zaffater Eye Center
- Joshua Wolf
- Emily Gay Womack
- Women of Diversity Inc
- Womens Health Specialists of Bossier
- Kristen Wood
All providers in Bossier City, LA · Family Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.