Individual
MARK ALLEN MOTLEY
Active
Individual
MARK ALLEN MOTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.003300
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00130216
ANTHEM
—
01
—
00164996
ANTHEM
OH
05
—
0333704
—
OH
01
—
1750494530
OHIO BWC
OH
01
—
791580458
RAILROAD MEDICARE
OH
Enumeration date
08/16/2006
Last updated
12/03/2020
Update your record
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