Theron Garrick Mccormick

MD | Pediatric Allergy-Immunology | Male

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Complete Profile:

Theron Garrick Mccormick basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Allergy/Immunology
Provider Name :	Theron Garrick Mccormick
Credential :	MD
Gender :	Male

Business Address:

Theron Garrick Mccormick address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	8200 Constantin Blvd Fl 3 Baton Rouge, LA, 70809-3481 United States
Phone Number :	225-765-5500
Fax Number :	225-765-4378

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1649367541
NPI Entity Type :	Individual
First Enrolment Date :	10 Oct, 2006
Last Updated On :	05 Feb, 2021

Medicare Participation:

Theron Garrick Mccormick participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	2163467465
Medicare Enrollment ID :	I20071003000692
Primary Specialty :	Allergy/immunology
Medical School :	Louisiana State University School Of Medicine In New Orleans
Graduation Year :	2000
Accepts Medicare?	Yes. Theron Garrick Mccormick accepts medicare insurance.

Group Practice Association:

Theron Garrick Mccormick is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Theron Garrick Mccormick is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Our Lady Of The Lake Physician Group Llc	4587849781	491	7777 Hennessy Blvd Baton Rouge, LA - 708084363	Yes
Our Lady Of The Lake Physician Group Llc	4587849781	491	8200 Constantin Blvd Baton Rouge, LA - 708093481	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Theron Garrick Mccormick are as mentioned. Primary taxonomy code for Theron Garrick Mccormick, MD is 2080P0201X (Pediatrics Pediatric Allergy/Immunology).

Taxonomy Code	Speciality	Primary	License No.	State
207K00000X	Allergy & Immunology	No	201441	LA
207K00000X	Allergy & Immunology	No	L5832	TX
2080P0201X	Pediatrics Pediatric Allergy/Immunology	Yes	201441	LA

Legacy Identifiers:

Other legacy medical identifiers of Theron Garrick Mccormick such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
1017973	MEDICAID	LA

Other Practice Locations:

Practice Address	City, State	Phone Number
7777 HENNESSY BLVD, SUITE 408 BATON ROUGE, LA, 70808-4300 United States	BATON ROUGE, LA	225-765-6834

Endpoints:

Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	5959 S Sherwood Forest Blvd Baton Rouge, LA, 70816-6038 United States
Phone Number :	225-526-0011
Fax Number :	225-765-9196

Business Location:

Patients can refer following map for directions to Theron Garrick Mccormick practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.