Darryl Fontaine MD

NPI 1023000429 - Anesthesiology - 207L00000X

NPI Details
NPI 1023000429
Gender Male
Enumeration Date 08/22/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
4105 FORT HENRY DRIVE
SUITE 207
KINGSPORT TN, 37663, US
Phone (423) 239-5833
Fax (423) 239-9789
Business Location
1 FONTAINE CT
KINGSPORT TN, 37660, US
Phone (423) 392-4981
Fax (423) 245-5032
Toxanomy
Taxonomy Code 207L00000X
License State Tennessee
License Number 20124
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According to our database, Darryl Fontaine MD NPI is 1023000429, taxonomy code is 207L00000X and license number is 20124, license state is located at Tennessee. Darryl Fontaine MD physically located at 4105 Fort Henry Drive, Kingsport TN, 37663. NPI Number Darryl Fontaine MD has the Individual type.

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1023000429 NPI number is provided on an as is basis without warranty of any kind. 1023000429 is maintained by the National Plan & Provider Enumeration System. The contents of Darryl Fontaine MD are for informational purposes only.