Individual
DR. JOHN MICHAEL MOTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6415
(928) 213-6409
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
17657
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
750299
—
AZ
Enumeration date
09/26/2006
Last updated
03/15/2017
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