Individual
DR. MATTHEW SHANE FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1214 COOLIDGE BLVD, LAFAYETTE, LA 70503-2621
(337) 289-7927
(337) 289-7935
Mailing address
PO BOX 53092, LAFAYETTE, LA 70505-3092
(337) 289-8978
(337) 289-8970
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
024987
LA
Other
Enumeration date
03/10/2006
Last updated
08/04/2009
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