# J.S. FONTENOT

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

## Provider details

- **NPI number:** 1093984387
- **Authorized official:** DR. J.S. FONTENOT O.D. (DOCTOR)
- **Authorized official phone:** (337) 363-6060

## Contact information

- **Practice address:** 111 CALCASIEU ST, VILLE PLATTE, LA 70586-4401
- **Practice address phone:** (337) 363-6060
- **Practice address fax:** (337) 363-3649
- **Mailing address:** 111 CALCASIEU ST, VILLE PLATTE, LA 70586-4401
- **Mailing address phone:** (337) 363-6060
- **Mailing address fax:** (337) 363-3649

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 640286T | LA | Yes |

## Other

- **Enumeration date:** 02/21/2008
- **Last updated:** 05/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1032204 | — | LA |
| 01 | — | 110944 | EYEMED | LA |
| 01 | — | 21236 | BCBS | LA |