# JOHN PHIL FONTENOT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083724538
- **Authorized official:** JOHN P FONTENOT M.D. (OWNER)
- **Authorized official phone:** (337) 468-5150

## Contact information

- **Practice address:** 1415 7TH ST, SUITE K, MAMOU, LA 70554-2269
- **Practice address phone:** (337) 468-5150
- **Practice address fax:** (337) 468-5155
- **Mailing address:** 1415 7TH ST, SUITE K, MAMOU, LA 70554-2269
- **Mailing address phone:** (337) 468-5150
- **Mailing address fax:** (337) 468-5155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 200868 | LA | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020