Provider Demographics
NPI:1124173067
Name:FONTENOT, TOWANNA NECOLE (MD)
Entity type:Individual
Prefix:DR
First Name:TOWANNA
Middle Name:NECOLE
Last Name:FONTENOT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:25 MONUMENT RD STE 270
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5073
Practice Address - Country:US
Practice Address - Phone:717-741-8250
Practice Address - Fax:717-741-8289
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061467174400000X
PAMD468594207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist