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Mary Fontenot Anderson, MD

Family Medicine in Covington, LA. Individual provider (NPI-1).

NPI number1174053292
StatusActive
Last updated in NPPESNov 12, 2020

Details

NPI
1174053292
Entity type
Individual (NPI-1)
Name
Mary Fontenot Anderson
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Jun 13, 2017
Certification date
Nov 12, 2020
Last updated
Nov 12, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine309400LAYes

Practice location

100 Christwood Blvd
Covington, LA 70433-4606

Phone 985-256-5690

Mailing address

100 Christwood Blvd
Covington, LA 70433-4606

Phone 985-256-5690

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