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General NPI Number Information
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NPI Number | 1376555250
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Entity Type | Individual
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Provider Name | RYAN J PLANK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 500 E 109TH AVE
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City | CROWN POINT
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State | IN
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Zip | 46307-7294
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Country | US
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Telephone | 219-921-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 601 GATEWAY BLVD N
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City | CHESTERTON
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State | IN
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Zip | 46304-9658
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Country | US
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Telephone | 219-921-1444
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Fax | 219-921-0533
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 01059354A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01059354A
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License Number State | IN
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