Healthcare Provider Details

I. General information

NPI: 1386538700
Provider Name (Legal Business Name): LORI PLONSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 JOHNSON FY RD NE STE 300
ATLANTA GA
30342-1418
US

IV. Provider business mailing address

875 JOHNSON FY RD NE STE 300
ATLANTA GA
30342-1418
US

V. Phone/Fax

Practice location:
  • Phone: 404-835-4191
  • Fax:
Mailing address:
  • Phone: 404-257-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number103321
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: