Individual
EUDICE E. FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS WAY, MAIL SLOT 512-3, LITTLE ROCK, AR 72202-3500
(501) 364-1479
(501) 364-3667
Mailing address
1 CHILDREN'S WAY, MAIL SLOT 512-3, LITTLE ROCK, AR 72202-3510
(501) 364-1479
(501) 364-3667
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
E-2037
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124535001
—
AR
Enumeration date
10/13/2006
Last updated
03/03/2011
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