Provider Demographics
NPI:1942298732
Name:MOTTO, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MOTTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23503
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37422-3503
Mailing Address - Country:US
Mailing Address - Phone:423-443-3524
Mailing Address - Fax:423-899-5632
Practice Address - Street 1:4355 HIGHWAY 58
Practice Address - Street 2:SUITE 107A
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-2939
Practice Address - Country:US
Practice Address - Phone:423-443-3524
Practice Address - Fax:423-899-5632
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14144207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000342295DMedicaid
TN3194148Medicaid
TN0025162OtherBLUECROSS BLUESHILED
GA000342295DMedicaid
TN3194148Medicaid