SOUTH SHREVEPORT INTERNAL MEDICINE

SHREVEPORT, LA
NPI1982635249
Entity TypeOrganization
Authorized ContactGREG J. GAVIN
Network Administrator
318-212-4232
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Enumeration Date2006-07-05
Last Update Date2022-08-30
Business Address
SOUTH SHREVEPORT INTERNAL MEDICINE
2508 BERT KOUNS INDUSTRIAL LOOP SUITE 301
SHREVEPORT, LA 71118-3133
Phone number: 318-212-5991
Mailing Address
SOUTH SHREVEPORT INTERNAL MEDICINE
2508 BERT KOUNS INDUSTRIAL LOOP SUITE 301
SHREVEPORT, LA 71118-3133
Phone number: 318-212-5991
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