Individual
MRS. SHELLY C MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
503 MCMILLAN RD, WEST MONROE, LA 71291
(318) 329-8310
(318) 329-8313
Mailing address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
021354
LA
208000000X
Pediatrics Physician
35C.000651
OH
208000000X
Pediatrics Physician
DR.0063225
CO
208000000X
Pediatrics Physician
DR.63225
CO
2080A0000X
Pediatric Adolescent Medicine Physician
021354
LA
2080A0000X
Pediatric Adolescent Medicine Physician
30575
MS
2080N0001X
Neonatal-Perinatal Medicine Physician
021354
LA
2080N0001X
Neonatal-Perinatal Medicine Physician
30575
MS
208M00000X
Hospitalist Physician
35C.000651
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0024372
—
OH
05
—
1551104
—
LA
Enumeration date
08/26/2005
Last updated
04/07/2026
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