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Individual

DR. KRISTEN LEE PONTIFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8300 CONSTANTIN BLVD, BATON ROUGE, LA 70809-3489
(225) 374-1410
(225) 374-1616
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0011
(225) 765-9196

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
54756
TN
208000000X
Pediatrics Physician
54756
TN
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
326610
LA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
54756
TN

Other

Enumeration date
04/10/2013
Last updated
06/10/2021
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