WK Spine Institute

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

WK SPINE INSTITUTE

Practice address

2551 Greenwood Rd
Suite 320
Shreveport, LA 71103-3981

Phone

(318) 212-8546

Fax

(318) 212-4153

NPI assigned

Jan 22, 2010

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) 212-4232

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1992036412",
    "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": "318-212-4889",
            "fax_number": "318-212-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD",
            "address_2": "SUITE 320",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033981",
            "telephone_number": "318-212-8546",
            "fax_number": "318-212-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK SPINE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-09-16",
        "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": "318-212-4232"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WK South Shreveport Family Practice
• WK South Shreveport Womens Health Clinic
• WK South Surgical Hospitalists
• WK Spectrum Neurosurgery-the Brain & Spine Specialist
• WK Spine Clinic
• WK Surgical Consultants
• WK Tots to Teens Pediatric Center
• WK Transplant Physicians
• WK Tri-State Medical Clinic
• WK Tri-State Neurosurgery Associates

• Neurological Surgery Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Neurological Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.