Provider Demographics
NPI:1053319400
Name:PLYLER, JOHN WILLIAMS (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAMS
Last Name:PLYLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 118008
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29423-8008
Mailing Address - Country:US
Mailing Address - Phone:843-569-1856
Mailing Address - Fax:843-569-1879
Practice Address - Street 1:9313 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 310
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9155
Practice Address - Country:US
Practice Address - Phone:843-569-1856
Practice Address - Fax:843-569-1879
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC123632084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC123636Medicaid
SCP00953716OtherRAIL ROAD MEDICARE
SCPL0102OtherMEDICAID SLEEP LAB
SCP00953716OtherRAIL ROAD MEDICARE
SCD176988798Medicare PIN
SCD176987356Medicare PIN
SCAA72356868Medicare PIN
SCPL0102OtherMEDICAID SLEEP LAB
SCAA72357006Medicare PIN
SCAA72747126Medicare PIN
SCAA72356834Medicare PIN