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MONICA LAROSE HAYNES MD AND WILLIS-KNIGHTON MEDICAL CENTER NPI 1891721130


NPI Information

NPI: 1891721130
Provider Name: MONICA LAROSE HAYNES MD AND WILLIS-KNIGHTON MEDICAL CENTER
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
7847 YOUREE DR
SHREVEPORT, LA
ZIP 71105
Phone: (318) 212-3930
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MONICA LAROSE HAYNES 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. MONICA LAROSE HAYNES MD AND WILLIS-KNIGHTON MEDICAL CENTER NPI is 1891721130. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7847 YOUREE DR
SHREVEPORT, LA
ZIP 71105-505
Phone: (318) 212-3930
Fax: (318) 212-3935

The provider's authorized official is Greg J. Gavin .
The authorized official title is Network Administrator and has the following contact phone number (318) 212-3930.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 12/14/2007.


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

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11487082MEDICAIDLOUISIANA

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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