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WK CHILD NEUROLOGY NPI 1639587496


NPI Information

NPI: 1639587496
Provider Name: WK CHILD NEUROLOGY
Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Organization

Specialization: Neurology with Special Qualifications in Child Neurology

Address:
2530 BERT KOUNS INDUSTRIAL LOOP
SUITE 113
SHREVEPORT, LA
ZIP 71118
Phone: (318) 212-5811
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WK CHILD NEUROLOGY is a neurology with special qualifications in child neurology psychiatry neurology in Shreveport, LA. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. WK CHILD NEUROLOGY NPI is 1639587496. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2530 BERT KOUNS INDUSTRIAL LOOP
SUITE 113
SHREVEPORT, LA
ZIP 71118-132
Phone: (318) 212-5811
Fax: (318) 212-5844

The provider's authorized official is Greg J Gavin .
The authorized official title is Network Administrator and has the following contact phone number (318) 212-8780.

The enumeration date for this NPI number is 7/24/2014 and was last updated on 7/24/2014.


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
12084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyYes

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: 4/28/2024

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