1588967889 NPI number — DR. STEVEN LAWRENCE PLAXCO JR. O.D.

Table of content: DR. STEVEN LAWRENCE PLAXCO JR. O.D. (NPI 1588967889)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588967889 NPI number — DR. STEVEN LAWRENCE PLAXCO JR. O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PLAXCO
Provider First Name:
STEVEN
Provider Middle Name:
LAWRENCE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
O.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588967889
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GENERAL LEONARD WOOD COMMUNITY HOSPITAL
Provider Second Line Business Mailing Address:
4234 ILLINOIS AV
Provider Business Mailing Address City Name:
FORT LEONARD WOOD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65473-9098
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-596-0048
Provider Business Mailing Address Fax Number:
910-907-6069

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GENERAL LEONARD WOOD COMMUNITY HOSPITAL
Provider Second Line Business Practice Location Address:
4234 ILLINOIS AV
Provider Business Practice Location Address City Name:
FORT LEONARD WOOD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65473-9098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-596-0048
Provider Business Practice Location Address Fax Number:
910-907-6069
Provider Enumeration Date:
12/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  0620000098 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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