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Individual

CHRISTOPHER DAVID FONTIMAYOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
KEESLER AFB, 301 FISHER STREET, BILOXI, MS 39534
(228) 382-8833
Mailing address
KEESLER AFB, 301 FISHER STREET, BILOXI, MS 39534

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
78398
GA
390200000X
Student in an Organized Health Care Education/Training Program
6571
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
11/12/2009
Last updated
04/19/2018
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