Individual
JANET LESLIE PLAXICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1201 E. ROSS BYPASS ROAD, TAHLEQUAH, OK 74464
(918) 207-0991
(918) 456-7570
Mailing address
PO BOX 1008, TAHLEQUAH, OK 74465-1008
(918) 207-0991
(918) 456-7570
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
772
OK
363AS0400X
Surgical Physician Assistant
Primary
PA772
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094770A
—
OK
Enumeration date
07/10/2006
Last updated
05/12/2010
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