MEDICARE: OTIS A PLUNK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PS0010X	Sports Medicine (Emergency Medicine) Physician	054852	GA

General Provider Information

NPI Number	:	1104824069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OTIS A PLUNK MD

Provider Business Mailing Address
First Line	:	1140 HAMMOND DR NE
Second Line	:	BUILDING I, STE 9100
City	:	ATLANTA
State	:	GA
Zip	:	30328-5338
Country	:	US
Telephone Number	:	770-393-1362
Fax Number	:	770-393-1743

Provider Business Practice Location Address
First Line	:	1140 HAMMOND DR NE
Second Line	:	BUILDING I, STE 9100
City	:	ATLANTA
State	:	GA
Zip	:	30328-5338
Country	:	US
Telephone Number	:	770-393-1362
Fax Number	:	770-393-1743

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1255339107 — LIFETEST OF GEORGIA, LLC
Practice Location Address:

1140 HAMMOND DR NE , BUILDING I, STE 9120
ATLANTA, GA
30328-5338

Practice Phone: 770-730-0119
Practice Fax: 770-730-0114

1457350068 — STUART STEPHEN KATZ MD
Practice Location Address:

1140 HAMMOND DR NE , SUITE 300
ATLANTA, GA
30328-5338

Practice Phone: 404-851-5400
Practice Fax: 404-851-5401

1528068632 — JONATHAN D WINNER MD
Practice Location Address:

1140 HAMMOND DR NE , SUITE E5250
ATLANTA, GA
30328-5338

Practice Phone: 404-256-2688
Practice Fax: 404-256-1820

1780684894 — SALLY J MARCUS
Practice Location Address:

1140 HAMMOND DR NE , STE E 5250
ATLANTA, GA
30328-5338

Practice Phone: 404-256-2688
Practice Fax: 404-256-1820

1316947427 — NANCY A ILGENFRITZ NP
Practice Location Address:

1140 HAMMOND DR NE , SUITE E 5250
ATLANTA, GA
30328-5338

Practice Phone: 404-256-2688
Practice Fax: 404-256-1820

1457351553 — MRS. WENDY H GREENBERG MD
Practice Location Address:

1140 HAMMOND DR NE , STE E 5250
ATLANTA, GA
30328-5338

Practice Phone: 404-256-2688
Practice Fax: 404-256-1820

Directions to “ OTIS A PLUNK MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.