Individual
JOHN FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1860 E EGBERT ST, BRIGHTON, CO 80601-2475
(303) 659-4000
(303) 659-9306
Mailing address
203 S ROLLIE AVE, FORT LUPTON, CO 80621-1508
(303) 286-4560
(303) 286-4589
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0046182
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54071577
—
CO
Enumeration date
07/15/2008
Last updated
11/07/2013
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