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Individual
CHARLES EDWARD FONTENOT
Active
Individual
CHARLES EDWARD FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
010529
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1101923
—
LA
01
—
5J379
MEDICARE INDIVIDUAL
LA
Enumeration date
06/17/2006
Last updated
07/13/2026
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