Individual
CLINT M CORMIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP STE 210, SHREVEPORT, LA 71118-3175
(318) 212-5860
(318) 212-5865
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP STE 210, SHREVEPORT, LA 71118-3175
(318) 212-5860
(318) 212-5865
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
024745
LA
207V00000X
Obstetrics & Gynecology Physician
Primary
M6087
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1553760
—
LA
05
—
159052305
—
TX
01
—
8F9683
BCBSTX
TX
Enumeration date
06/08/2005
Last updated
06/23/2021
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