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Contact Information

WK SHREVEPORT CENTER FOR GERIATRIC HEALTH
2508 BERT KOUNS LOOP
SUITE 303
SHREVEPORT, LA71118-3133
 Phone: 318-212-5850
 Fax: 318-212-5855
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for WK SHREVEPORT CENTER FOR GERIATRIC HEALTH · (Female)

NPI Number 1114256476
Status Active
Credentials
Entity Individual
Enumeration date 12/16/2009
Last updated 01/23/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA Medicaid 1818798
  • LA Other 5DL73 MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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