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General NPI Number Information
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NPI Number | 1154503241
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Entity Type | Organization
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Legal Business Name | LOUIS H MCCORMICK MD, LLC
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 606 HAIFLEIGH ST
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City | FRANKLIN
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State | LA
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Zip | 70538-3731
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Country | US
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Telephone | 337-828-4440
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Fax |
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Provider Business Mailing Address
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Address Line | 606 HAIFLEIGH ST
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City | FRANKLIN
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State | LA
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Zip | 70538-3731
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Country | US
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Telephone | 337-828-4440
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LOUIS H MCCORMICK
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Credential | MD
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Telephone | 337-828-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 04661R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 04661R
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License Number State | LA
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