Provider Demographics
NPI:1033553284
Name:CORMIER, ALLISON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:CORMIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 ENTERPRISE DR STE B
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5405
Mailing Address - Country:US
Mailing Address - Phone:985-262-1639
Mailing Address - Fax:985-262-8197
Practice Address - Street 1:605 ENTERPRISE DR STE B
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-5405
Practice Address - Country:US
Practice Address - Phone:985-262-1639
Practice Address - Fax:985-262-8197
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1033553284207RI0200X
390200000X
LA308698207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty