Search › Louisiana › 183500000X
Derek Fontenot
NPI 1609311927 · on the registry since 2016 · sole proprietor
Practice
- Address
- 2011 Ryan St
Lake Charles, LA 70601 - Phone
- (337) 508-3864
- Organisation at this address
- Wal-Mart Stores East Lp
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-12-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana