Shane Bennett Fontenot O.D.

NPI 1164612529 - Optometrist - 152W00000X

NPI Details
NPI 1164612529
Gender Male
Enumeration Date 07/31/2007
Last Updated 10/07/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
1702 JOHNSON ST
JENNINGS LA, 70546-3624, US
Phone (337) 824-1112
Fax (337) 824-9112
Business Location
1702 JOHNSON ST
JENNINGS LA, 70546-3624, US
Phone (337) 824-1112
Fax (337) 824-9112
Toxanomy
Taxonomy Code 152W00000X
License State Louisiana
License Number 1540
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According to our database, Dr. Shane Bennett Fontenot O.D. NPI is 1164612529, taxonomy code is 152W00000X and license number is 1540, license state is located at Louisiana. Shane Bennett Fontenot O.D. physically located at 1702 Johnson St, Jennings LA, 70546-3624. NPI Number Shane Bennett Fontenot O.D. has the Individual type.

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1164612529 NPI number is provided on an as is basis without warranty of any kind. 1164612529 is maintained by the National Plan & Provider Enumeration System. The contents of Shane Bennett Fontenot O.D. are for informational purposes only.