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WK KINNEBREW AND JOHNSON CLINIC
NPI 1902085186
Family Medicine in Shreveport, LA

Active since October 24, 2007
2508 BERT KOUNS LOOP STE 102, SHREVEPORT, LA 71118(318) 688-6630(318) 688-6014 Get Directions Write a Review

NPPES record last updated: June 8, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Wk Kinnebrew And Johnson Clinic NPPES

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

WK KINNEBREW AND JOHNSON CLINIC (NPI 1902085186) is a healthcare organization registered as a family medicine in Shreveport, Louisiana and active in the NPI registry since October 2007. The organization lists Greg J. Gavin, Network Administrator, as its authorized official.

NPPES Registry Identity

NPI1902085186
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWK KINNEBREW AND JOHNSON CLINIC
Location Address2508 BERT KOUNS LOOP STE 102Shreveport, LA 71118-3175
Mailing Address2508 Bert Kouns Loop Ste 102Shreveport, LA 71118-3175 · (318) 688-6630 · Fax (318) 688-6014
Phone(318) 688-6630
Fax(318) 688-6014
Organization SubpartNo
Authorized OfficialGreg J. GavinNetwork Administrator · (318) 212-4232
Enumeration DateOctober 24, 2007
Last NPPES UpdateJune 8, 2012
✔ NPI 1902085186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2508 BERT KOUNS LOOP STE 102, Shreveport, LA 71118
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Other Identifiers 2

Medicare PIN5BD08LA
Medicaid1021652LA

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

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 Wk Kinnebrew And Johnson Clinic's NPI number?

The NPI number for Wk Kinnebrew And Johnson Clinic is 1902085186. It was assigned to this organization in the NPPES registry on October 24, 2007.

Where is Wk Kinnebrew And Johnson Clinic located?

Wk Kinnebrew And Johnson Clinic is located at 2508 Bert Kouns Loop Ste 102, Shreveport, LA 71118. The listed phone number is (318) 688-6630.

What is Wk Kinnebrew And Johnson Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Wk Kinnebrew And Johnson Clinic was last updated on June 8, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.