Individual
DARRYL FONTAINE
Active
Individual
DARRYL FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20124
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00013859
NHC CARE ADMINISTRATORS
—
05
—
0221312000
—
WV
01
—
063263
ANTHEM BCBS
—
01
—
100011235
PHP TENNCARE
—
01
—
3046989
BLUE SHIELD OF TN
—
05
—
3051034
—
TN
05
—
5747040
—
VA
05
—
64911142
—
KY
05
—
890576L
—
NC
01
—
TN0100
JOHN DEERE
—
Enumeration date
08/22/2005
Last updated
07/08/2007
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