Healthcare Provider Details

I. General information

NPI: 1427109503
Provider Name (Legal Business Name): PLOOT P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W WASHINGTON ST
KALISPELL MT
59901
US

IV. Provider business mailing address

125 W WASHINGTON ST
KALISPELL MT
59901-3950
US

V. Phone/Fax

Practice location:
  • Phone: 406-755-1300
  • Fax: 406-752-8346
Mailing address:
  • Phone: 406-755-1300
  • Fax: 406-752-8346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number155
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number166
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIM ERIK PLOOT
Title or Position: OWNER
Credential: DPM
Phone: 406-755-1300