| NPI | 1407964349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES EDWARD FONTENOT President 337-363-5521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD010529) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |