Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 35-068633 | OH |
N | 2081P2900X | Pain Medicine | 33648 | KY |
NPI | 1073526000 |
---|---|
Provider Name | Dr. James Michael Plunkett |
First Address | Villa Hills, KY 41017-1164 |
Second Address | Cincinnati, OH 45220-2213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
33648 | STATE MEDICAL LICENSE # (01) | KY |
35-068633 | STATE MEDICAL LICENSE (01) | OH |
G-08743 | (02) | OH |