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General NPI Number Information
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NPI Number | 1003881558
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Entity Type | Individual
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Provider Name | RAY FONTENOT M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/20/2006
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 101 3RD AVE SW
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City | MINOT
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State | ND
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Zip | 58701-3880
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Country | US
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Telephone | 701-857-5986
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Fax | 701-857-5029
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Provider Business Mailing Address
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Address Line | 101 3RD AVE SW
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City | MINOT
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State | ND
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Zip | 58701-3880
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 17541
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | PT17541
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | H1081
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License Number State | TX
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