Individual
DR. JEFFREY DOUGLAS FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1122 SOUTH BERNARD RD, SUITE B, BROUSSARD, LA 70518
(337) 289-8933
Mailing address
PO BOX 53092, LAFAYETTE, LA 70505-3092
(337) 289-8933
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
328521
LA
Other
Enumeration date
03/21/2018
Last updated
11/03/2021
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