Organization
PRIMARY ANESTHESIA SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
W. DEAN FONTENOT (CRNA)
(337) 616-7150
Entity
Organization
Contact information
Practice address
1634 ELTON RD, JENNINGS, LA 70546-3614
(337) 616-7150
(337) 616-7164
Mailing address
1634 ELTON RD, JENNINGS, LA 70546-3614
(337) 616-7150
(337) 616-7164
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
38458
LA
Other
Enumeration date
03/08/2007
Last updated
08/22/2020
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