Provider Demographics
NPI:1578786406
Name:ASH-MOTT, CARRIE F (MD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:F
Last Name:ASH-MOTT
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:PO BOX 616788
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6788
Mailing Address - Country:US
Mailing Address - Phone:407-447-7120
Mailing Address - Fax:407-770-0661
Practice Address - Street 1:1766 E CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1945
Practice Address - Country:US
Practice Address - Phone:702-843-2440
Practice Address - Fax:833-749-0349
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ43426207Q00000X
NV16202207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ531096Medicaid
NV1578786406Medicaid
NV1578786406Medicaid
Z139878Medicare PIN