Organization
FONTENOT & MCINTOSH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
H JERREL FONTENOT M.D., PHD. (PRESIDENT)
(318) 322-1339
Entity
Organization
Contact information
Practice address
1275 GLENWOOD DR, WEST MONROE, LA 71291-5539
(318) 322-1339
Mailing address
PO BOX 2850, RUSTON, LA 71273-2850
(800) 903-4859
(601) 936-0686
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1446157
—
LA
01
—
DB1967
RR MEDICARE
—
Enumeration date
05/19/2006
Last updated
04/15/2014
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