Healthcare Provider Details

I. General information

NPI: 1114912888
Provider Name (Legal Business Name): LAURIE M MCCORMICK MD, DFAPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURIE M MCCORMICK MD

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 7TH AVE SW STE 100
CEDAR RAPIDS IA
52404-2185
US

IV. Provider business mailing address

42 7TH AVE SW STE 100
CEDAR RAPIDS IA
52404-2185
US

V. Phone/Fax

Practice location:
  • Phone: 319-800-2125
  • Fax: 855-300-4759
Mailing address:
  • Phone: 319-800-2125
  • Fax: 855-300-4759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35045
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1957
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: