Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 24109 (ARIZONA) | AZ |
N | 207N00000X | Dermatologist | ARIZONA 24109 | AZ |
N | 207ND0101X | MOHS-Micrographic Surgeon | 24109 | AZ |
N | 207ND0101X | MOHS-Micrographic Surgeon | ARIZONA 24109 | AZ |
NPI | 1003924218 |
---|---|
Provider Name | Ms. Lora J. Plattner |
First Address | Scottsdale, AZ 85260-6411 |
Second Address | Scottsdale, AZ 85260-6411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 21/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G17897 | (02) | |
G17897 | (02) | AZ |