DR. ANGELIQUE THAIS FONTENETTE (NPI# 1376695098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376695098 |
| Entity Type | Individual |
| Full Name | DR. ANGELIQUE THAIS FONTENETTE |
| Credential | M.D. |
| Practice Address |
Jefferson Regional Medical Center 1600 West 40th Pine Bluff AR 71603 |
| Mailing Address |
11810 Shady Ridge Dr Little Rock AR 72211-4589 |
| Practice Telephone | 5015417100 |
| Mailing Telephone | 5012280527 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
N8418 | AR | Allopathic & Osteopathic Physicians |
| Street Address |
JEFFERSON REGIONAL MEDICAL CENTER 1600 WEST 40TH |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154975431 | Cabot Ep, Pllc | Emergency Medicine | 212 Willie Ray Dr., Cabot, AR 72023 | 2019-07-25 |
| 1518249929 | Doc Network, Inc. | Emergency Medicine | 11705 E Creek Ln, Farmington, AR 72730-9564 | 2011-09-12 |
| 1972666147 | Ted Shields | Emergency Medicine | 1710 Mayfield Drive, Jonesboro, AR 72401 | 2006-12-19 |
| 1356400634 | Gilbert Howard Kimball | Emergency Medicine | Yell County Hospital Dardanelle 200 North Third St., Dardanelle, AR 72834 | 2006-12-06 |
| 1023107935 | Khalid Rayaz | Emergency Medicine | 13212 Fairview Village Court, Little Rock, AR 72205-4417 | 2006-10-11 |
| 1538256680 | Gregory Hall | Emergency Medicine | 4301 W Markham St # 584, Little Rock, AR 72205-7101 | 2006-10-09 |
| 1982715058 | Nes Western Arkansas, Inc | Emergency Medicine | East Main & South 20th St, Van Buren, AR 72956 | 2006-08-31 |
| 1295754075 | Roderick Rene Boyd | Emergency Medicine | 460 W Oak St Ste 601, El Dorado, AR 71730-4538 | 2006-07-19 |
| 1528007838 | Martin John Carey | Emergency Medicine | 1 Briar Patch Ct, Little Rock, AR 72211-4425 | 2006-06-05 |
| 1285257105 | City of Perryville | Emergency Medicine | 512 6th St, Perryville, AR 72126 | 2020-05-27 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
Please comment or provide details below to improve the information on DR. ANGELIQUE THAIS FONTENETTE.
| 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.