Individual
THOMAS J FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
202 RUE BORDEAUX, CARENCRO, LA 70520-4328
(337) 298-5937
Mailing address
202 RUE BORDEAUX, CARENCRO, LA 70520-4328
(337) 298-5937
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN065361
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1654574
—
LA
Enumeration date
08/25/2006
Last updated
07/08/2007
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