| Organization Name: | WK PORTICO PEDIATRICS |
| NPI Number: | 1083940191 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREG J. GAVIN (NETWORK ADMINISTRATOR) |
| Mailing Address: | 7847 Youree Dr Shreveport |
| State: | LA US |
| Postal Code: | 711055505 |
| Phone Number: | 3182123930 |
| Fax Number: | 3182123935 |
| NPI Enumeration Date: | 10/23/2009 |
| NPI Last Update Date: | 10/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |