Individual
DR. MICHAEL E MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
86 PALMETTO RD, RAYVILLE, LA 71269-6415
(318) 728-2970
(318) 728-7111
Mailing address
86 PALMETTO RD, RAYVILLE, LA 71269-6415
(318) 728-2970
(318) 729-7111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
12771R
LA
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
12771R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1555380
—
LA
Enumeration date
06/16/2006
Last updated
08/21/2019
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