WK CHILD NEUROLOGY NPI 1639587496

NPI Information

  • NPI: 1639587496
  • Provider Name: WK CHILD NEUROLOGY
  • Classification: Psychiatry & Neurology - 2084N0402X
  • Specialization: Neurology with Special Qualifications in Child Neurology
  • Entity Type: Organization
  • Address: 2530 BERT KOUNS INDUSTRIAL LOOP
    SUITE 113
    SHREVEPORT, LA
    ZIP 71118
  • Phone: (318) 212-5811

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NPI Details

WK CHILD NEUROLOGY is a neurology with special qualifications in child neurology psychiatry neurology in Shreveport, LA. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. WK CHILD NEUROLOGY NPI is 1639587496. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2530 BERT KOUNS INDUSTRIAL LOOP
SUITE 113
SHREVEPORT, LA
ZIP 71118-132
Phone: (318) 212-5811
Fax: (318) 212-5844

The provider's authorized official is Greg J Gavin .
The authorized official title is Network Administrator and has the following contact phone number (318) 212-8780.

The enumeration date for this NPI number is 7/24/2014 and was last updated on 7/24/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyYes

What is NPI?

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This page was last updated on: 3/30/2025

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