Individual
BENJAMIN SCOTT FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
277 N HIGHWAY 171 STE 8, LAKE CHARLES, LA 70611-5374
(337) 312-0030
(337) 312-0033
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-0030
(337) 312-0033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
306762
LA
Other
Enumeration date
03/25/2014
Last updated
11/28/2017
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