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General NPI Number Information
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NPI Number | 1588476022
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Entity Type | Organization
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Legal Business Name | WK RHEUMATOLOGY PIERREMONT
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 8001 YOUREE DR STE 720
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City | SHREVEPORT
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State | LA
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Zip | 71115-2336
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Country | US
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Telephone | 318-212-3833
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Fax | 318-212-3841
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Provider Business Mailing Address
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Address Line | 8001 YOUREE DR STE 720
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City | SHREVEPORT
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State | LA
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Zip | 71115-2336
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Country | US
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Telephone | 318-212-3833
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Fax | 318-212-3841
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Authorized Official
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Title or Position | VP PHYSICIAN NETWORK
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Name | JARED THOMAS BEVILLE
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Credential |
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Telephone | 318-716-4939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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