Provider Demographics
NPI:1770575011
Name:LAPLATA, MARSHALL R (DO)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:R
Last Name:LAPLATA
Suffix:
Gender:M
Credentials:DO
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 299
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37349-0299
Mailing Address - Country:US
Mailing Address - Phone:931-728-5607
Mailing Address - Fax:931-728-8354
Practice Address - Street 1:1821 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2221
Practice Address - Country:US
Practice Address - Phone:931-455-2005
Practice Address - Fax:931-455-4450
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO1201207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5635554OtherAETNA PPO
TN6357OtherHEALTH 123
TN2375737004OtherCIGNA PLAN 139
TN980269OtherAETNA HMO
TN2040222OtherUHC
TN3064339OtherB/S OF TN
TN3304941Medicaid
TN2375737008OtherCIGNA PLAN 110
TN5635554OtherAETNA PPO
TN3304941Medicare ID - Type UnspecifiedMEDICARE #