MEDICARE: EUGENE FONTENOT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	014734	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275538993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE FONTENOT M.D.

Provider Business Mailing Address
First Line	:	1514 JEFFERSON HWY
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70121-2429
Country	:	US
Telephone Number	:	504-842-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4150 NELSON RD
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-4148
Country	:	US
Telephone Number	:	337-474-2056
Fax Number	:	337-477-9334

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	06/09/2025

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Directions to “ EUGENE FONTENOT M.D.” Practice Location

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