OrganizationActive
Wk Pediatric Intensivist
NPI 1023074549 · Pediatric Critical Care Medicine Physician · Shreveport, LA
Provider details
- NPI number
- 1023074549
- Entity type
- Organization
- Primary specialty
- Pediatric Critical Care Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Greg Gavin, Network Administrator(318) 212-3868
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2510 Bert Koun Loop Rm 4003
Shreveport, LA 71118-3119
Phone: (318) 212-5665
Fax: (318) 212-5698
Approximate (ZIP-level) locationGet directions
Mailing address
2510 Bert Koun Loop Rm 4003
Shreveport, LA 71118-3119
Registry dates
- Enumerated
- 2006-04-24
- Last updated
- 2018-05-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.