Provider Demographics
NPI:1912403924
Name:LAUTREDOU, CASSANDRA COLEMAN (MD)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:COLEMAN
Last Name:LAUTREDOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:SHEREAN
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4815 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3866
Mailing Address - Country:US
Mailing Address - Phone:501-534-6202
Mailing Address - Fax:
Practice Address - Street 1:4601 W MARKHAM ST # 639
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3897
Practice Address - Country:US
Practice Address - Phone:501-686-8000
Practice Address - Fax:501-526-5148
Is Sole Proprietor?:No
Enumeration Date:2018-03-30
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-17568207R00000X, 207RI0200X
CAA174552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE10431OtherLICENSE
CAA174552OtherCALIFORNIA MEDICAL LICENSE PHYSICIAN AND SURGEON A