Provider Demographics
NPI:1972765063
Name:BARBARA PLUCKNETT MD
Entity Type:Organization
Organization Name:BARBARA PLUCKNETT MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUCKNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-344-9997
Mailing Address - Street 1:3 W OLIVE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2572
Mailing Address - Country:US
Mailing Address - Phone:570-961-9947
Mailing Address - Fax:570-341-5043
Practice Address - Street 1:743 JEFFERSON AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1635
Practice Address - Country:US
Practice Address - Phone:570-344-9997
Practice Address - Fax:570-344-3158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059852L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016282140002Medicaid
PA0016282140002Medicaid
G10406Medicare UPIN