Individual
JOHN P. FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1415 7TH ST, SUITE J, MAMOU, LA 70554-2269
(337) 468-5150
(337) 468-5155
Mailing address
1415 7TH ST, SUITE J, MAMOU, LA 70554-2269
(337) 468-5155
(337) 468-5155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200868
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1066125
—
LA
Enumeration date
06/22/2006
Last updated
07/12/2010
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