Individual
REED A FONTENOT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2016 OAK PARK BLVD, LAKE CHARLES, LA 70601-7828
(337) 477-8861
(337) 477-3092
Mailing address
2016 OAK PARK BLVD, LAKE CHARLES, LA 70601-7828
(337) 477-8861
(337) 477-3092
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
010029
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05242
BCBS
LA
05
—
1110744
—
LA
Enumeration date
12/30/2005
Last updated
04/08/2008
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