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1598794612
WILLIS-KNIGHTON MEDICAL CENTER MICHELLE SELF MD
SHREVEPORT, LA
NPI
1598794612
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Entity Type
Organization
Authorized Contact
GREG J. GAVIN
Network Administrator
318-212-3810
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2006-07-01
Last Update Date
2020-08-22
Business Address
WILLIS-KNIGHTON MEDICAL CENTER MICHELLE SELF MD
8001 YOUREE DR SUITE 540
SHREVEPORT, LA 71115-2302
Phone number: 318-212-3810
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Mailing Address
WILLIS-KNIGHTON MEDICAL CENTER MICHELLE SELF MD
8001 YOUREE DR SUITE 540
SHREVEPORT, LA 71115-2302
Phone number: 318-212-3810
Copy
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