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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

NPI Number 1114256476
LBN Legal business name WK SHREVEPORT CENTER FOR GERIATRIC HEALTH
Authorized official GREG GAVIN - (NETWORK ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 12/16/2009
Last updated 01/23/2014 - About 12 years ago
Identifiers
LA Medicaid 1818798
LA Other 5DL73 MEDICARE PTAN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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