Individual
CODEY LANCE FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7373 PERKINS RD, BATON ROUGE, LA 70808-4326
(225) 769-4044
Mailing address
7373 PERKINS RD, BATON ROUGE, LA 70808-4326
(225) 769-4044
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.205619
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205619
STATE LICENSE
LA
Enumeration date
04/14/2011
Last updated
02/27/2017
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