Healthcare Provider Details

I. General information

NPI: 1033477138
Provider Name (Legal Business Name): ALEXANDER D PLOCKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALEX PLOCKI D.O.

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 01/24/2020
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-3460
  • Fax: 504-842-3468
Mailing address:
  • Phone: 504-842-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS018973
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO.000450
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: