Individual
WILLIAM L FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
709 HOLLYBROOK DR STE 3401, LONGVIEW, TX 75605-2412
(903) 753-1778
(903) 753-7202
Mailing address
PO BOX 610393, DALLAS, TX 75261-0393
(903) 291-6187
(903) 237-1810
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
43514
TN
207X00000X
Orthopaedic Surgery Physician
Primary
L0176
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1503997
—
TN
Enumeration date
11/15/2005
Last updated
12/12/2019
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