Provider Demographics
NPI:1881857035
Name:WK ARKLATEX UROLOGY AND PROSTATE CANCER INSTITUTE
Entity Type:Organization
Organization Name:WK ARKLATEX UROLOGY AND PROSTATE CANCER INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-716-4939
Mailing Address - Street 1:2449 HOSPITAL DR STE 340
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-1912
Mailing Address - Country:US
Mailing Address - Phone:318-212-7850
Mailing Address - Fax:318-212-7858
Practice Address - Street 1:2449 HOSPITAL DR STE 340
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-1912
Practice Address - Country:US
Practice Address - Phone:318-212-7850
Practice Address - Fax:318-212-7858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty