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Organization

CHARLES F MOTLEY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES F MOTLEY M.D. (PC)
(219) 872-7247
Entity
Organization

Contact information

Practice address
6916 W JOHNSON RD, LA PORTE, IN 46350-6548
(219) 872-7247
(219) 879-8609
Mailing address
6916 W JOHNSON RD, LA PORTE, IN 46350-6548
(219) 872-7247
(219) 879-8609

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100163900A
IN
Enumeration date
03/20/2013
Last updated
09/24/2013
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