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General NPI Number Information
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NPI Number | 1740661883
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Entity Type | Organization
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Legal Business Name | GULF STATES REHABILITATION & ASSOCIATES
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 4224 HOUMA BLVD STE 470
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City | METAIRIE
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State | LA
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Zip | 70006-2980
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Country | US
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Telephone | 504-456-5160
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Fax | 504-456-5021
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Provider Business Mailing Address
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Address Line | 4224 HOUMA BLVD STE 470
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City | METAIRIE
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State | LA
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Zip | 70006-2980
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Country | US
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Telephone | 504-456-5160
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Fax | 504-456-5021
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM ROSS KNIGHT
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Credential | D.O.
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Telephone | 504-456-5160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D.O.0818OR
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License Number State | LA
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