MEDICARE: CANAL WOME'S CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	025394	LA

General Provider Information

NPI Number	:	1679722029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANAL WOME'S CLINIC

Provider Business Mailing Address
First Line	:	3316 CANAL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-6206
Country	:	US
Telephone Number	:	504-827-2345
Fax Number	:

Provider Business Practice Location Address
First Line	:	3316 CANAL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-6206
Country	:	US
Telephone Number	:	504-827-2345
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KEVIN G WORK
Credential	:
Telephone Number	:	504-669-8860

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	09/10/2008

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Directions to “CANAL WOME'S CLINIC ” Practice Location

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