Individual
DR. LAWRENCE J MOTACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
300 2ND AVE NE, JAMESTOWN, ND 58401
(701) 252-2020
(701) 251-2801
Mailing address
300 2ND AVE NE, JAMESTOWN, ND 58401
(701) 252-2020
(701) 251-2801
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
486
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01013875
PREFERRED ONE
ND
01
—
0255160001
CIGNA MEDICARE
ND
01
—
2200303
MEDICA
ND
01
—
410030693
TRAVELERS MEDICARE
ND
05
—
60463
—
ND
01
—
870486
NOVSI
ND
Enumeration date
07/10/2006
Last updated
08/23/2010
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