Mccormick, Theron Garrick

Mccormick, Theron Garrick is an individual health care provider with primary practice located at 8200 Constantin Blvd Fl 3 , Baton Rouge LA 70809-3481. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology. Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology is his primary health care specialty. Mccormick, Theron Garrick can be contacted via phone (225) 765-5500.

Contact Information

Primary practice address
8200 Constantin Blvd Fl 3 Baton Rouge LA 70809-3481
Phone: (225) 765-5500
Fax: (225) 765-4378
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 201441 Louisiana
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X L5832 Texas
Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology 2080P0201X 201441 Louisiana

Profile Details

NPI number 1649367541
LBN Legal business name Mccormick, Theron Garrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Feb 5th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649367541 NPPES
Louisiana MEDICAID 1017973

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