Wk Pediatric Intensivist
Pediatric Critical Care Medicine
Wk Pediatric Intensivist is a Shreveport, Louisiana based Pediatric center with medical specialization in
Pediatric Critical Care Medicine.
It is located at
2510 Bert Koun Loop Rm 4003, Shreveport, Louisiana - 71118-3119. They can be contacted on phone at
318-212-5665 and fax number 318-212-5698.
NPI number (Unique professional ID) for Wk Pediatric Intensivist is
1023074549 which was assigned by NPPES on 24 Apr, 2006 and it was last updated on 09 May, 2018.
Wk Pediatric Intensivist is expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Complete Profile:
Wk Pediatric Intensivist basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Critical Care Medicine |
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| Provider Name : | Wk Pediatric Intensivist |
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Business Address:
Wk Pediatric Intensivist address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2510 Bert Koun Loop Rm 4003
Shreveport, LA, 71118-3119
United States |
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| Phone Number : | 318-212-5665 |
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| Fax Number : | 318-212-5698 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1023074549 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 24 Apr, 2006 |
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| Last Updated On : | 09 May, 2018 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Gregj. Gavin |
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| Official Title or Position : | NETWORK ADMINISTRATOR |
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| Phone Number : | 318-212-3868 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Wk Pediatric Intensivist are as mentioned. Primary taxonomy code for Wk Pediatric Intensivist is
2080P0203X (Pediatrics Pediatric Critical Care Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0203X | Pediatrics Pediatric Critical Care Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Wk Pediatric Intensivist such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 1099091 | MEDICAID | LA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2510 Bert Koun Loop Rm 4003
Shreveport, LA, 71118-3119
United States |
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| Phone Number : | 318-212-5665 |
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| Fax Number : | 318-212-5698 |
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Business Location:
Patients can refer following map for directions to
Wk Pediatric Intensivist practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.