Provider Demographics
NPI:1558569087
Name:PLOTT, RONALD TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:TODD
Last Name:PLOTT
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 1:12469 TIMBERLAND BLVD
Mailing Address - Street 2:STE 501
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6548
Mailing Address - Country:US
Mailing Address - Phone:480-206-1064
Mailing Address - Fax:
Practice Address - Street 1:12469 TIMBERLAND BLVD
Practice Address - Street 2:STE 501
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6548
Practice Address - Country:US
Practice Address - Phone:817-431-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8330207N00000X
CAC53567207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology