Provider Demographics
NPI:1336721786
Name:WILLIS KNIGHTON HEALTH SYSTEM
Entity Type:Organization
Organization Name:WILLIS KNIGHTON HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECOVERY AUDIT COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEFANIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-212-2695
Mailing Address - Street 1:2600 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3908
Mailing Address - Country:US
Mailing Address - Phone:318-212-2695
Mailing Address - Fax:318-212-2689
Practice Address - Street 1:2600 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3908
Practice Address - Country:US
Practice Address - Phone:318-212-2695
Practice Address - Fax:318-212-2689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital