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General NPI Number Information
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NPI Number | 1669540043
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Entity Type | Individual
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Provider Name | JENNIFER PLUNKETT MD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 20 GLENLAKE PKWY DEPARTMENT OF SURGERY
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City | ATLANTA
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State | GA
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Zip | 30328-3473
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Country | US
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Telephone | 770-677-6227
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Fax |
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Provider Business Mailing Address
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Address Line | 1106 OGLETHORPE DR NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-2783
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Country | US
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Telephone | 404-414-8211
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 058554
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License Number State | GA
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