Provider Demographics
NPI:1033140637
Name:FONTANE, ROBERT LEPINE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEPINE
Last Name:FONTANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3311 PRESCOTT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3917
Mailing Address - Country:US
Mailing Address - Phone:318-442-3384
Mailing Address - Fax:318-442-3385
Practice Address - Street 1:3311 PRESCOTT RD STE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3917
Practice Address - Country:US
Practice Address - Phone:318-442-3384
Practice Address - Fax:318-442-3385
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2020-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAMD200548208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAI50033Medicare UPIN