MEDICARE: ERIC NEIL PLOTNICK 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	207YS0012X	Sleep Medicine (Otolaryngology) Physician	51712	GA
2	207Y00000X	Otolaryngology Physician	051712	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689657892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC NEIL PLOTNICK MD

Provider Business Mailing Address
First Line	:	619 S 8TH ST
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30224-4260
Country	:	US
Telephone Number	:	470-956-4371
Fax Number	:

Provider Business Practice Location Address
First Line	:	619 S 8TH ST
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30224-4260
Country	:	US
Telephone Number	:	470-956-4371
Fax Number	:

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	06/30/2021

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