Organization
WOMEN'S MEDICAL & SURGICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. UPENDRA M KULKARNI M.D. (PRESIDENT)
(337) 468-2250
Entity
Organization
Contact information
Practice address
805 CHERRY ST, MAMOU, LA 70554-2223
(337) 468-2250
(337) 468-2702
Mailing address
805 CHERRY ST, MAMOU, LA 70554-2223
(337) 468-2250
(337) 468-2702
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
05120R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811866
AMERIGROUP CCN
LA
05
—
1811866
—
LA
01
—
1900461332
CLIA
LA
01
—
4507365
EMC
LA
01
—
5DL47
MEDICARE PTAN
LA
01
—
P10000361561
LA HEALTHCARE CONNECTIONS CCN
LA
Enumeration date
08/28/2009
Last updated
04/02/2014
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