Individual
FERNANDO MOTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4400
(918) 619-4960
Mailing address
PO BOX 268838, OKLAHOMA CITY, OK 73126-8838
(918) 634-7500
(918) 634-7560
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
40505
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201188040A
—
OK
Enumeration date
04/19/2019
Last updated
03/26/2025
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