| Paul S Wilson Md And Willis-knighton Medical Center | |
|
1666 E Bert Kouns Industrial Loop Suite 230 Shreveport LA 71105-5714 | |
| (318) 212-3970 | |
| (318) 212-3975 |
| Full Name | Paul S Wilson Md And Willis-knighton Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 1666 E Bert Kouns Industrial Loop, Shreveport, Louisiana |
| Authorized Official Name and Position | Greg J. Gavin (NETWORK ADMINISTRATOR) |
| Authorized Official Contact | 3182123970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul S Wilson Md And Willis-knighton Medical Center 1666 E Bert Kouns Industrial Loop Suite 230 Shreveport LA 71105-5714 Ph: (318) 212-3970 | Paul S Wilson Md And Willis-knighton Medical Center 1666 E Bert Kouns Industrial Loop Suite 230 Shreveport LA 71105-5714 Ph: (318) 212-3970 |
| NPI Number | 1003847013 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003847013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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