| Charles F Motley Pc | |
|
6916 W Johnson Rd La Porte IN 46350-6548 | |
| (219) 872-7247 | |
| (219) 879-8609 |
| Full Name | Charles F Motley Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6916 W Johnson Rd, La Porte, Indiana |
| Authorized Official Name and Position | Charles F Motley (PC) |
| Authorized Official Contact | 2198727247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles F Motley Pc 6916 W Johnson Rd La Porte IN 46350-6548 Ph: (219) 872-7247 | Charles F Motley Pc 6916 W Johnson Rd La Porte IN 46350-6548 Ph: (219) 872-7247 |
| NPI Number | 1538401286 |
|---|---|
| Provider Enumeration Date | 03/20/2013 |
| Last Update Date | 09/24/2013 |
| Medicare PECOS PAC ID | 7517101876 |
|---|---|
| Medicare Enrollment ID | O20130926000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538401286 | NPI | - | NPPES |
| 100163900A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Charles F Motley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316948789 PECOS PAC ID: 2365491982 Enrollment ID: I20050823000339 |
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