Healthcare Provider Details

I. General information

NPI: 1851212526
Provider Name (Legal Business Name): MR. CAMERON PAUL CORMIER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 RUE BEAUREGARD STE F
LAFAYETTE LA
70508-8511
US

IV. Provider business mailing address

117 HARTON RD
YOUNGSVILLE LA
70592-6386
US

V. Phone/Fax

Practice location:
  • Phone: 337-534-0254
  • Fax:
Mailing address:
  • Phone: 337-412-3741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: