Wk Tri-State Medical Clinic

LBN: Wk Tri-State Medical Clinic
Wk Tri-State Medical Clinic is an health care organization with primary practice located at 2551 Greenwood Rd Suite 410, Shreveport LA 71103-3981. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Wk Tri-State Medical Clinic can be contacted via phone (318) 621-2929, or through Gavin, Greg J. via phone (318) 212-4571.

Contact Information

Primary practice address
2551 Greenwood Rd Suite 410 Shreveport LA 71103-3981
Phone: (318) 621-2929
Fax: (318) 621-2930
Website:
Map and Directions
Authorized official contact:
Name: Gavin, Greg J.
Phone: (318) 212-4571

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1225082746
LBN Legal business name Wk Tri-State Medical Clinic
DBA Doing business as
Authorized official Gavin, Greg J.
Entity Organization
Organization subpart 1 No
Enumeration date May 20th, 2006
Last updated Oct 5th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225082746 NPPES
Louisiana MEDICAID 1448419

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