Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Wk Pines Road Family Medicine

Organization Family Medicine Physician · NPI 1629210042

Wk Pines Road Family Medicine provides Family Medicine Physician services in Shreveport, Louisiana. Registered with an NPI since 2009.

In the registry since
2009

Practice location Address checks out

9111 Susan Dr
Shreveport, LA 71118-3136
Phone: (318) 212-5969
Fax: (318) 212-5979
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1629210042
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Ward — Sr Vp Finance · (318) 716-4939
NPI enumeratedMarch 31, 2009
Last updated in NPPESMarch 5, 2026
Certification dateMarch 5, 2026
Mailing address9111 Susan Dr, Shreveport, LA 71118-3136

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