| Wk Pinnacle Gastroenterology | |
|
2551 Greenwood Rd Suite 350 Shreveport LA 71103-3981 | |
| (318) 212-8710 | |
| (318) 212-8699 |
| Full Name | Wk Pinnacle Gastroenterology |
|---|---|
| Speciality | Internal Medicine |
| Location | 2551 Greenwood Rd, Shreveport, Louisiana |
| Authorized Official Name and Position | Greg J. Gavin (NETWORK ADMINISTRATOR) |
| Authorized Official Contact | 3182124571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wk Pinnacle Gastroenterology 2551 Greenwood Rd Suite 350 Shreveport LA 71103-3981 Ph: (318) 212-8710 | Wk Pinnacle Gastroenterology 2551 Greenwood Rd Suite 350 Shreveport LA 71103-3981 Ph: (318) 212-8710 |
| NPI Number | 1669455226 |
|---|---|
| Provider Enumeration Date | 11/28/2005 |
| Last Update Date | 06/08/2012 |
| Medicare PECOS PAC ID | 6608898259 |
|---|---|
| Medicare Enrollment ID | O20051222000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669455226 | NPI | - | NPPES |
| 1448834 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Thomas Ryan Palmer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578619912 PECOS PAC ID: 5799885695 Enrollment ID: I20070706000294 |
| Provider Name | Patricia Lynne Strickland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851898621 PECOS PAC ID: 6305100918 Enrollment ID: I20180508000828 |
| Provider Name | Sherif Michael |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699185884 PECOS PAC ID: 9830318252 Enrollment ID: I20220315000541 |
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