Individual
DR. CODY FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
6940 PINES RD, SHREVEPORT, LA 71129-2516
(318) 682-8188
Mailing address
6201 BERT KOUNS INDUSTRIAL LOOP, LOT #341, SHREVEPORT, LA 71129-5056
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.020602
LA
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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