| Dr Ray Fontenot, MD | |
|
101 3rd Ave Sw, Minot, ND 58701-3880 | |
| (701) 857-5986 | |
| (701) 857-5029 |
| Full Name | Dr Ray Fontenot |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Location | 101 3rd Ave Sw, Minot, North Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003881558 | NPI | - | NPPES |
| 128721103 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 17541 (North Dakota) | Secondary |
| 207Y00000X | Otolaryngology | PT17541 (North Dakota) | Secondary |
| 207Y00000X | Otolaryngology | H1081 (Texas) | Primary |
| Entity Name | Southeast Texas Ear, Nose & Throat, Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962477406 PECOS PAC ID: 8426063736 Enrollment ID: O20060208000093 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ray Fontenot, MD 101 3rd Ave Sw, Minot, ND 58701-3880 Ph: () - | Dr Ray Fontenot, MD 101 3rd Ave Sw, Minot, ND 58701-3880 Ph: (701) 857-5986 |
Sina Koochakzadeh, Otolaryngology Medicare: Medicare Enrolled Practice Location: 2305 37th Ave Sw, Minot, ND 58701 Phone: 701-418-7530 Fax: 701-418-7531 | |
Dr. Robert L Fischer, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 101 3rd Ave Sw, Minot, ND 58701 Phone: 701-857-5986 | |
Stephanie Rae Velimirovich, FNP Otolaryngology Medicare: Medicare Enrolled Practice Location: 2305 37th Ave Sw Ste 502, Minot, ND 58701 Phone: 701-418-7530 | |
Robert G Thomas, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 2305 37th Ave Sw, Minot, ND 58701 Phone: 701-857-5000 |