Individual
DR. JASON FONTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2809 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 809-5510
(228) 809-5519
Mailing address
2809 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 809-5510
(228) 809-5519
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MS17948
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009944055
—
AL
01
—
646000515E
BLUE CROSS OF MS
—
05
—
JF09280201
—
MS
01
—
P00054446
MEDICARE RAILROAD
—
Enumeration date
01/17/2007
Last updated
03/04/2014
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