Doctor Name: | MR. SAMUEL MILTON PLUCKER |
NPI Number: | 1942418496 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 240 Medical Park Blvd Suite 3000 Bristol, TN - 376207346 |
Business Phone Number: | 4239902400 |
Business Fax Number: | 4239902405 |
Mailing Address: | Po Box 9, KINGSPORT |
State: | TN |
Postal Code: | 376620009 |
Phone Number: | 4238572093 |
Fax Number: | 4238572070 |
NPI Enumeration Date: | 05/18/2007 |
NPI Last Update Date: | 07/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |