DR. PHILIP ANDRE FONTENOT JR. (NPI# 1790121424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790121424 |
| Entity Type | Individual |
| Full Name | DR. PHILIP ANDRE FONTENOT JR. |
| Credential | M.D. |
| Practice Address |
50 Bear Dr Greenville SC 29605 |
| Mailing Address |
50 Bear Dr Greenville SC 29605-4458 |
| Practice Telephone | 8642952131 |
| Mailing Telephone | 8642952131 |
| Mailing Fax Number | 8642698035 |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2018-06-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 51583 | SC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Saint Francis Dr, Greenville, SC 296013955 | 8642551000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306232731 | Philip Fontenot | Orthopaedic Surgery | 18444 N 25th Ave Ste 210, Phoenix, AZ 85023-1264 | 2015-04-13 |
| 1184844144 | Philip A. Fontenot | Dentist | 4733 Andrew Jackson Pkwy, Suite 1-a, Hermitage, TN 37076-1365 | 2007-05-01 |
| Street Address |
50 BEAR DR |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225659048 | Katrina Colquhoun | Speech-Language Pathologist | 50 Bear Dr, Greenville, SC 29605-4458 | 2020-05-04 |
| 1386167757 | Lindsey Russ Owens | Nurse Practitioner | 50 Bear Dr, Greenville, SC 29605-4458 | 2017-07-18 |
| 1366996753 | Tara Nicole Feather | Speech-Language Pathologist | 50 Bear Dr, Greenville, SC 29605-4458 | 2016-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588955652 | St Francis Physician Services Inc | Urology | 200 Andrews St Ste 100, Greenville, SC 29601-3974 | 2011-04-25 |
| 1578760450 | Kimberly Lynn Burgess | Urology | 15 Park Creek Dr, Greenville, SC 29605-4270 | 2007-07-02 |
| 1922021856 | Anthony John Elisco IIi | Urology | 4215 Joe Ramsey Blvd E # 203, Greenville, TX 75401-7852 | 2006-07-25 |
| 1063462836 | Donald R. Vaughan | Urology | 18 Memorial Medical Drive, Greenville, SC 29605 | 2006-05-11 |
| 1477519098 | James Howard Sandin | Urology | 4818 Welllington, Suite 4, Greenville, TX 75402 | 2006-04-22 |
| 1073574141 | Lisa Maria Cartwright | Urology | 200 Patewood Dr Ste A115, Greenville, SC 29615-3547 | 2006-03-29 |
| 1760479968 | William Patrick Springhart | Urology | 11 Park Creek Dr, Greenville, SC 29605-4270 | 2005-10-03 |
| 1124020946 | Walter P Beh | Urology | 81 N Main St, Greenville, PA 16125-1781 | 2005-08-11 |
| 1811994940 | Woodrow Wilson Long Jr. | Urology | 18 Memorial Medical Dr, Greenville, SC 29605-4452 | 2005-07-05 |
| 1295197507 | Owensboro Health Medical Group, Inc. | Urology | 440 Hopkinsville St, Greenville, KY 42345-1124 | 2016-03-25 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
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| 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.