Provider Demographics
NPI:1205902525
Name:PLOOT, KIM ERIK (DPM)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:ERIK
Last Name:PLOOT
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3950
Mailing Address - Country:US
Mailing Address - Phone:406-755-1300
Mailing Address - Fax:406-752-8346
Practice Address - Street 1:125 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-755-1300
Practice Address - Fax:406-752-8346
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT155213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0390847Medicaid
MT0173836Medicaid
U85261Medicare UPIN