| Organization Name: | WILLIS KNIGHTON MEDICAL CENTER, INC. |
| NPI Number: | 1487693149 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT D HUIE (EXECUTIVE VICE PRESIDENT) |
| Mailing Address: | 3300 Albert L Bicknell Dr Suite 3 Shreveport |
| State: | LA US |
| Postal Code: | 711033903 |
| Phone Number: | 3182124697 |
| Fax Number: | 3182128377 |
| NPI Enumeration Date: | 06/06/2006 |
| NPI Last Update Date: | 07/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 17 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |