Individual
BRANDI JEAN FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-4050
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD205702
LA
208M00000X
Hospitalist Physician
Primary
205702
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2150146
—
LA
Enumeration date
03/18/2011
Last updated
02/09/2022
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