WK PEDIATRIC EYE SPECIALISTS NPI 1548408628

NPI Information

WK PEDIATRIC EYE SPECIALISTS is a general practice in Shreveport, LA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee WK PEDIATRIC EYE SPECIALISTS NPI is 1548408628. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1202 LOUISIANA AVE
SHREVEPORT, LA
ZIP 71101-910
Phone: (318) 212-8946
Fax: (318) 212-4153

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 1/28/2009 and was last updated on 6/11/2012.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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