MR. BRIAN KEITH FONTENOT


Address: 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943
Phone: 3182279777

MR. BRIAN KEITH FONTENOT (NPI# 1790228013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790228013
Entity Type Individual
Full Name MR. BRIAN KEITH FONTENOT
Credential PA-C
Practice Address 2751 Albert L Bicknell Dr Ste 5c
Shreveport
LA 71103-3943
Practice Telephone 3182279777
Practice Fax Number 3184591188
Mailing Telephone 3182279777
Mailing Fax Number 3184591188
Enumeration Date 2016-11-18
Last Update Date 2019-12-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
303880 LA Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
6701 Fannin St, Houston, TX 770302608 8328241000

Office Location

Street Address 2751 ALBERT L BICKNELL DR STE 5C
City SHREVEPORT
State LA
Zip Code 71103-3943

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609474428 Thea Christine Fontenot Physician Assistant 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 2020-10-14
1700401908 Amanda Marie Davis Nurse Practitioner 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 2020-06-12
1437774635 April Chase Nurse Practitioner 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 2020-06-12
1275011256 Amy Fontenot Physician Assistant 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103 2018-08-01
1386137586 Emily Leanne Welch Nurse Practitioner 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 2018-06-12
1194243899 Serena Shah Frye Physician Assistant 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 2017-09-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083124887 Elizabeth Ponder Case Manager/Care Coordinator 404 Hearne Avenue, Shreveport, LA 71103 2017-10-05
1245648393 Madiha Tariq General Acute Care Hospital Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 2014-07-31
1659782688 Jennifer G Smith Pharmacist 1725 Claiborne Ave, Shreveport, LA 71103 2014-05-13
1336568823 Taylor Jieun Jung Student in an Organized Health Care Education/Training Program Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 2014-04-10
1578984746 Jamie Terrell Pharmacist 1625 Claiborne Ave, Shreveport, LA 71103 2013-12-13
1346675188 Srijan Tandukar Internal Medicine 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 2013-09-12
1699017681 Deanna Elise Mossallati Internal Medicine 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 2013-03-18
1346527330 Tim M Smith Clinical Exercise Physiologist 3200 Greenwood Rd., Shreveport, LA 71103 2011-11-04
1144451683 Second Chance Recovery Durable Medical Equipment & Medical Supplies 3816 Linwood, Shreveport, LA 71103 2009-07-31
1093919920 Neeraj Singh Internal Medicine 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 2007-06-13
Find all providers in zip 71103

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1831412626 Christopher Micheal Magill Physician Assistant 2551 Greenwood Rd Ste 210, Shreveport, LA 71103-3985 2010-03-08
1851401426 Teresa Bigler Physician Assistant 1606 Kings Hwy, Shreveport, LA 71103-4128 2006-08-30
1730118365 Tina Faith Gentry Physician Assistant 7925 Youree Dr Suite 280b, Shreveport, LA 71105-5538 2006-07-03
1487616538 David Stanley Staton Physician Assistant Overton Brooks Vamc, 510 East Stoner Ave, Shreveport, LA 71101 2006-04-04
1114924404 Mary Mcferren Physician Assistant 1455 E Bert Kouns Industrial Loop # 200, Shreveport, LA 71105 2005-07-01
1487252029 Melissa Raney Physician Assistant 2709 Mackey Ln, Shreveport, LA 71118-2556 2020-10-15
1629683230 Amanda Renae Simmons Physician Assistant 1541 Kings Hwy, Shreveport, LA 71103-4228 2020-09-10
1700496312 Caroline Leigh Harris Physician Assistant 1541 Kings Hwy, Shreveport, LA 71103-4228 2020-08-07
1811459449 Lyndsey Pate Day Physician Assistant 1541 Kings Hwy, Shreveport, LA 71103-4228 2019-04-02
1497139695 Amanda Barnes Physician Assistant 7045 Youree Dr, Shreveport, LA 71105-5108 2015-07-17
Find all providers in SHREVEPORT

Competitor

Search similar providers

City SHREVEPORT
Zip Code 71103

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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