Provider Demographics
NPI:1811935612
Name:MOTSENBOCKER, ERIK BYRON (MD)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:BYRON
Last Name:MOTSENBOCKER
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 1:341 WALLACE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-8000
Mailing Address - Country:US
Mailing Address - Phone:615-834-3123
Mailing Address - Fax:615-834-3008
Practice Address - Street 1:341 WALLACE RD
Practice Address - Street 2:SUITE A
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-8000
Practice Address - Country:US
Practice Address - Phone:615-834-3123
Practice Address - Fax:615-834-3008
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD41017207P00000X
TN41017208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00377600OtherRAILROAD MEDICARE
TN4132922OtherBLUECROSS
TNQ007974Medicaid
TN4150272OtherBLUECROSS
TNQ016135Medicaid
I23661Medicare UPIN
TN4132922OtherBLUECROSS
TNP00377600OtherRAILROAD MEDICARE