Provider Type Icon

WK BOSSIER RIVER CITIES INTERVENTIONAL PAIN SPECIALISTS NPI 1528393907


NPI Information

NPI: 1528393907
Provider Name: WK BOSSIER RIVER CITIES INTERVENTIONAL PAIN SPECIALISTS
Classification: Anesthesiology - 207LP2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 19D2002718

Address:
2449 HOSPITAL DR
SUITE 300
BOSSIER CITY, LA
ZIP 71111
Phone: (318) 212-7960
Get Directions

WK BOSSIER RIVER CITIES INTERVENTIONAL PAIN SPECIALISTS is a pain medicine anesthesiology in Bossier City, LA. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. WK BOSSIER RIVER CITIES INTERVENTIONAL PAIN SPECIALISTS NPI is 1528393907. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2449 HOSPITAL DR
SUITE 300
BOSSIER CITY, LA
ZIP 71111-399
Phone: (318) 212-7960
Fax: (318) 212-7965

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 19D2002718 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2009 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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207LP2900XAnesthesiologyPain MedicineYes

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
11803537MEDICAIDLOUISIANA
25DK70MEDICARE PINLOUISIANA

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

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.