Individual
MELISSA MITCHELL MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., F.A.A.P.
Contact information
Practice address
7777 HENNESSY BLVD STE 7000, BATON ROUGE, LA 70808-0307
(225) 765-8829
(225) 765-8283
Mailing address
781 COLONIAL DR, BATON ROUGE, LA 70806-6537
(225) 490-5440
(225) 490-5489
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
201439
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012343
—
LA
05
—
157435201
—
TX
Enumeration date
04/24/2006
Last updated
02/05/2021
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