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NPI Code Detail

MEDICARE: PHILLIP PLISKY DPT, ATC, CSCS, OCS

MEDICARE: PHILLIP PLISKY DPT, ATC, CSCS, OCS
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
1225100000XPhysical Therapist05006207AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000302815OTHERINBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245215813
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP PLISKY DPT, ATC, CSCS, OCS
Provider Business Mailing Address
First Line : 7300 E INDIANA ST
Second Line :
City : EVANSVILLE
State : IN
Zip : 47715-2794
Country : US
Telephone Number : 812-476-0409
Fax Number : 812-476-1016
Provider Business Practice Location Address
First Line : 533 W COLUMBIA ST
Second Line :
City : EVANSVILLE
State : IN
Zip : 47710-1617
Country : US
Telephone Number : 812-759-3001
Fax Number : 812-401-9013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 12/29/2008

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Directions to “ PHILLIP PLISKY DPT, ATC, CSCS, OCS” Practice Location

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