Individual
MR. BOBBY JAMES FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
601 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5726
(337) 436-1624
(337) 436-1621
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8360
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07217
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2332236
—
LA
Enumeration date
02/17/2013
Last updated
07/21/2014
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