Healthcare Provider Details

I. General information

NPI: 1265403448
Provider Name (Legal Business Name): TIMOTHY FRANCIS MOTT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 N MCKENZIE ST STE 101
FOLEY AL
36535-4703
US

IV. Provider business mailing address

1851 N MCKENZIE ST STE 101
FOLEY AL
36535-4703
US

V. Phone/Fax

Practice location:
  • Phone: 251-424-1232
  • Fax: 251-424-1954
Mailing address:
  • Phone: 251-949-3479
  • Fax: 251-949-3434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20216
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: