Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Theron Garrick McCormick, MD

Individual provider Allergy & Immunology Physician · NPI 1649367541

Theron Garrick McCormick, MD is an Allergy/Immunology in Baton Rouge, Louisiana. Graduated from Louisiana State University School of Medicine in New Orleans in 2000, 26 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Louisiana and Texas.

Years since qualifying
26
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
LA, TX
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

8200 Constantin Blvd Fl 3
Baton Rouge, LA 70809-3481
Phone: (225) 765-5500
Fax: (225) 765-4378
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 — (225) 765-6834

Specialties & licences

Pediatric Allergy/Immunology Physician (primary) Taxonomy 2080P0201X · Licence 201441 (LA)
Allergy & Immunology Physician Taxonomy 207K00000X · Licence 201441 (LA)
Allergy & Immunology Physician Taxonomy 207K00000X · Licence L5832 (TX)

Record details

NPI number1649367541
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 10, 2006
Last updated in NPPESFebruary 5, 2021
Certification dateFebruary 5, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyALLERGY/IMMUNOLOGY
Also practisesPEDIATRIC MEDICINE
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2000 (26 years in practice)
Group practice Our Lady Of The Lake Physician Group Llc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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