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General NPI Number Information
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NPI Number | 1912403924
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Entity Type | Individual
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Provider Name | CASSANDRA COLEMAN LAUTREDOU MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 4601 W MARKHAM ST # 639
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3897
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Country | US
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Telephone | 501-686-8000
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Fax | 501-526-5148
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Provider Business Mailing Address
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Address Line | 4815 W MARKHAM ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3866
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Country | US
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Telephone | 501-534-6202
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E-17568
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | E-17568
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License Number State | AR
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