# ADVANCED FAMILY EYECARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Family Eyecare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215121652
- **Authorized official:** DR. SHANE B FONTENOT OD (OWNER)
- **Authorized official phone:** (337) 263-3058

## Contact information

- **Practice address:** 1702 JOHNSON ST, JENNINGS, LA 70546-3624
- **Practice address phone:** (337) 824-1112
- **Practice address fax:** (337) 824-9112
- **Mailing address:** 1702 JOHNSON ST, JENNINGS, LA 70546-3624
- **Mailing address phone:** (337) 824-1112
- **Mailing address fax:** (337) 824-9112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 1540 | LA | Yes |

## Other

- **Enumeration date:** 08/29/2007
- **Last updated:** 07/25/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1020818 | — | LA |