Provider Demographics
NPI:1992787725
Name:PLANAVSKY, GEORGE J (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:J
Last Name:PLANAVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-3261
Mailing Address - Country:US
Mailing Address - Phone:608-466-6154
Mailing Address - Fax:608-519-5908
Practice Address - Street 1:444 MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-3261
Practice Address - Country:US
Practice Address - Phone:608-466-6154
Practice Address - Fax:608-519-5908
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2014-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN271822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN117949OtherUCARE
MN055508800Medicaid
MN39330PLOtherBCBS
MN260000192Medicare ID - Type Unspecified
MN055508800Medicaid