Individual
DR. ERIC CHARLES FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2770 3RD AVE STE 345, LAKE CHARLES, LA 70601-8994
(337) 494-4785
(337) 494-4786
Mailing address
PO BOX 122623 DEPT 2623, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD.206793
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2361325
—
LA
01
—
MD.206793
STATE LICENSE
LA
Enumeration date
04/22/2010
Last updated
04/27/2022
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