WILLIS-KNIGHTON MEDICAL CENTER MARK RICHARD MAINOUS
NPI 1720014145
Surgery - Surgical Critical Care in Bossier City, LA

Active since June 25, 2006
2400 HOSPITAL DR, SUITE 310, BOSSIER CITY, LA 71111(318) 212-7810(318) 212-7815 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Willis-knighton Medical Center Mark Richard Mainous NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIS-KNIGHTON MEDICAL CENTER MARK RICHARD MAINOUS (NPI 1720014145) is a healthcare organization registered as a surgical critical care in Bossier City, Louisiana and active in the NPI registry since June 2006. The organization lists Greg J. Gavin, Network Administrator, as its authorized official.

NPPES Registry Identity

NPI1720014145
Entity TypeOrganization
Primary Taxonomy2086S0102X
Legal Business NameWILLIS-KNIGHTON MEDICAL CENTER MARK RICHARD MAINOUS
Location Address2400 HOSPITAL DR, SUITE 310Bossier City, LA 71111-2385
Mailing Address2400 Hospital Dr, Suite 310Bossier City, LA 71111-2385 · (318) 212-7810 · Fax (318) 212-7815
Fax(318) 212-7815
Organization SubpartNo
Authorized OfficialGreg J. GavinNetwork Administrator · (318) 212-7810
Enumeration DateJune 25, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
NPI 1720014145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySurgery · Surgical Critical CareAllopathic & Osteopathic Physicians
Taxonomy Code2086S0102X
Definition
A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
2400 HOSPITAL DR, Bossier City, LA 71111

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
2400 HOSPITAL DR, SUITE 420
BOSSIER CITY, LA 71111
General Acute Care Hospital
2400 HOSPITAL DR
BOSSIER CITY, LA 71111
Internal Medicine
2400 HOSPITAL DR, SUITE 420
BOSSIER CITY, LA 71111
Obstetrics & Gynecology
2400 HOSPITAL DR, SUITE 240
BOSSIER CITY, LA 71111
Nurse Anesthetist, Certified Registered
2400 HOSPITAL DR
BOSSIER CITY, LA 71111
Internal Medicine
2400 HOSPITAL DR, SUITE 420
BOSSIER CITY, LA 71111
Ophthalmology
2400 HOSPITAL DR, SUITE 100
BOSSIER CITY, LA 71111
Ophthalmology
2400 HOSPITAL DR, SUITE 100
BOSSIER CITY, LA 71111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willis-Knighton Medical Center Mark Richard Mainous's NPI number?

The NPI number for Willis-Knighton Medical Center Mark Richard Mainous is 1720014145. It was assigned to this organization in the NPPES registry on June 25, 2006.

Where is Willis-Knighton Medical Center Mark Richard Mainous located?

Willis-Knighton Medical Center Mark Richard Mainous is located at 2400 Hospital Dr Suite 310, Bossier City, LA 71111. The listed phone number is (318) 212-7810.

What is Willis-Knighton Medical Center Mark Richard Mainous's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Critical Care, with taxonomy code 2086S0102X.

When was this NPI record last updated?

The NPPES record for Willis-Knighton Medical Center Mark Richard Mainous was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.