WK GYNECOLOGIC ONCOLOGY CLINIC NPI 1740493923

NPI Information

WK GYNECOLOGIC ONCOLOGY CLINIC is a gynecologic oncology obstetrics gynecology in Shreveport, LA. The provider is an obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. WK GYNECOLOGIC ONCOLOGY CLINIC NPI is 1740493923. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2600 KINGS HWY
SUITE 420
SHREVEPORT, LA
ZIP 71103-950
Phone: (318) 212-8727
Fax: (318) 212-8771

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 CLIA number assigned to this NPI record is 19D1072267 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 6/8/2012.

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.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.