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D GENE MACK JR MD AND WILLIS-KNIGHTON MEDICAL CENTER NPI 1134295520


NPI Information

NPI: 1134295520
Provider Name: D GENE MACK JR MD AND WILLIS-KNIGHTON MEDICAL CENTER
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1799 E BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT, LA
ZIP 71105
Phone: (318) 797-9000
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D GENE MACK JR MD AND WILLIS-KNIGHTON MEDICAL CENTER is a pediatrics in Shreveport, LA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. D GENE MACK JR MD AND WILLIS-KNIGHTON MEDICAL CENTER NPI is 1134295520. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1799 E BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT, LA
ZIP 71105-561
Phone: (318) 797-9000
Fax: (318) 797-9250

The provider's authorized official is Greg J Gavin .
The authorized official title is Network Administrator and has the following contact phone number (318) 212-4232.

The enumeration date for this NPI number is 11/28/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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