| Organization Name: | WK PLAIN DEALING MEDICAL CLINIC |
| NPI Number: | 1912939687 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREG J GAVIN (NETWORK ADMINISTRATOR) |
| Mailing Address: | 108 N Louisiana St Plain Dealing |
| State: | LA US |
| Postal Code: | 710643446 |
| Phone Number: | 3183267272 |
| Fax Number: | 3183267282 |
| NPI Enumeration Date: | 07/06/2006 |
| NPI Last Update Date: | 01/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |