Organization
CHARLES E. FONTENOT, M.D., A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES EDWARD FONTENOT M.D. (PRESIDENT)
(337) 363-5521
Entity
Organization
Contact information
Practice address
1535 W MAIN ST, VILLE PLATTE, LA 70586-2867
(337) 363-5521
(337) 363-9134
Mailing address
PO BOX 510, VILLE PLATTE, LA 70586-0510
(337) 363-5521
(337) 363-9134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD010529
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1101923
—
LA
01
—
4376284200
BLUE CROSS
LA
Enumeration date
08/29/2006
Last updated
08/22/2020
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