Provider Demographics
NPI:1003866112
Name:MOTLEY, CAROL PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:PATRICIA
Last Name:MOTLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1851 N MCKENZIE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-4703
Mailing Address - Country:US
Mailing Address - Phone:251-949-3479
Mailing Address - Fax:251-949-3434
Practice Address - Street 1:1851 N MCKENZIE ST STE 101
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-4703
Practice Address - Country:US
Practice Address - Phone:251-424-1232
Practice Address - Fax:251-424-1954
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2020-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL15466207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL215146Medicaid
AL51535691OtherBLUE CROSS
MS04934508Medicaid
AL009938102Medicaid
FL276284600Medicaid