Provider Demographics
NPI:1265590210
Name:PLAXCO, JERI SUE (DO)
Entity type:Individual
Prefix:DR
First Name:JERI
Middle Name:SUE
Last Name:PLAXCO
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2006 FRANKLIN ST SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4551
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2016-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KYR09272085R0202X
ALDO.9972085R0202X
CO505302085R0202X
NE12922085R0202X
WY9978A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology