BRIAN KEITH FONTENOT

SHREVEPORT, LA
NPI1790228013
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: LA  303880)
Enumeration Date2016-11-18
Last Update Date2021-07-12
Business Address
Mr. BRIAN KEITH FONTENOT PA-C
2751 ALBERT L BICKNELL DR STE 5C
SHREVEPORT, LA 71103-3943
Phone number: 318-227-9777
Mailing Address
Mr. BRIAN KEITH FONTENOT PA-C
2751 ALBERT L BICKNELL DR STE 5C
SHREVEPORT, LA 71103-3943
Phone number: 318-227-9777
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