Fontenot, Bennett
Fontenot, Bennett is an sole proprietor health care provider with primary practice located at 900 E Saint Mary Blvd Ste 104 , Lafayette LA 70503-2378. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Fontenot, Bennett can be contacted via phone (337) 504-3640.Contact Information
Primary practice address
900 E Saint Mary Blvd Ste 104
Lafayette LA 70503-2378
Phone: (337) 504-3640
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | LL30088 | South Carolina |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD.205820 | Louisiana |
Profile Details
| NPI number | 1033316310 |
|---|---|
| LBN Legal business name | Fontenot, Bennett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2007 |
| Last updated | Mar 17th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033316310 | NPPES |
| Louisiana | Other | 437739YJRA | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Louisiana | MEDICAID | 2400541 | PLASTIC AND RECONSTRUCTIVE SURGERY |
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